Sr Manager Clinical Compliance Reg Accreditation

HCA•Nashville, TN

64d•Hybrid

About The Position

The Internal Audit Department provides an independent appraisal function to validate management control systems and to support corporate management in the effective discharge of their responsibilities and efforts to achieve the Companys overall mission. The Clinical Compliance Team's work includes a variety of audits and performs onsite and/or remote assessments of focused areas within HCA Healthcare hospitals which include maintaining accreditation (i.e., The Joint Commission (TJC)), federal, state, and local regulations, emergency services, nursing services, etc. Audits also include testing of medical record documentation and corresponding bills to ensure compliance with company policies and government regulations. The purpose of the audits is to assist facility management in determining compliance with company-defined processes and CMS requirements. The team works closely with facility, division, and group management as well as corporate responsible personnel to help effect overall compliance. As the Clinical Compliance Audit Manager, you will work on various audit engagements with team members at various levels and receive formal evaluations twice a year.

Requirements

Active RN Licensure with 5 or more years' experience required.
BSN (from accredited School of Nursing) required.
Experience, and/or certification supporting regulatory/accreditation/safety compliance required.
Excellent communication skills in writing, speaking, and presenting.
Superior client service and business development skills, dedication to teamwork.
Ability to multitask and work well with deadlines/related time pressures
Proficient with Excel spreadsheet and Word processing software.
Ability to travel up to 25-30%.

Nice To Haves

Master's degree preferred.
Nursing management/supervisory experience preferred.

Responsibilities

Demonstrates a thorough understanding of The Joint Commission (TJC), The Centers for Medicare and Medicaid Services (CMS), federal and state regulations.
Performs onsite and/or remote focused assessments of regulatory and accreditation compliance including applicable federal, state, and local regulations and standards, emergency services, nursing services, and other clinical areas of organizational and/or patient safety and risk at HCA Healthcare facilities.
Conducts reviews of hospital/center systems to ensure compliance with applicable legal, regulatory and licensure requirements as defined by TJC, CMS, federal and state regulations and company policy for areas such as emergency services, nursing services, and other clinical areas of organizational and/or patient safety and risk.
Understands HCA Healthcare's business and the healthcare industry from a global perspective by recognizing business trends and emerging technical and industry developments of relevance and communicates these to the client engagement team and applicable management personnel.
Discusses complex auditing issues with engagement team and client management.
Communicates the objectives of each review and planned other services to the client engagement team and establishes/communicates team members' roles in the process.
Executes audit procedures, analyzes evidence, reaches conclusions, identifies issues, develops strategies, and makes decisions for complex, judgmental issues related to the review procedures executed. Consults with others in the Company, as necessary, on complex issues.
Reviews working papers and memoranda for consistency with applicable authoritative guidance and the requirements of the department.
Develops detailed reports specifying compliance issues identified during the audit.
Assists the facility with action plan development, follow-up questions. Completes process follow-up as necessary.
Provides input and guidance in the development of, as well as the review of the detailed audit/review programs particularly focusing on complex audit issues.
Participates in the audit quality assurance program.
Assists with educational and administrative matters (e.g. professional development programs, process improvement team initiatives, recruiting efforts, and special projects as requested by the Director).

Benefits

Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.