Supv Rehab - Regulatory and Compliance

Sharp HealthCare•San Diego, CA

13d

About The Position

This position is accountable for the ongoing development and compliance with regulatory requirements (including CARF, CMS and TJC), maintaining and developing regulatory data, and assisting with patient care and improvement initiatives to meet regulatory requirements across Sharp Acute Rehab Units. Assists rehab leadership teams with operational planning and compliance with billing and provides work direction to achieve unit and system level standard of care. Contributes to budget development and assists in managing administrative functions for rehabilitation and therapy as needed.

Requirements

Master's Degree Or Bachelor's Degree in Nursing
5 Years social work, rehab, or case management experience in a clinical setting.
3 Years experience with healthcare regulations and compliance. Experience to include enhancing quality care, compliance with internal standards, and regulatory and accreditation bodies such as CARF, CMS and TJC.
California Registered Nurse (RN) - CA Board of Registered Nursing OR Occupational Therapist Registered (OTR) - National Board for Certification in Occupational Therap y OR California Licensed Physical Therapist (PT) - CA Physical Therapy Board OR Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) - The American Speech-Language-Hearing Association (ASHA) OR California BBS Licensed Clinical Social Worker (LCSW) - CA Board of Behavioral Sciences -REQUIRED
Knowledge of fiscal and budgetary principles/practices.
Knowledge of Microsoft Office suite (Word, Excel, Outlook, Teams, etc.).
Ability to remain flexible in rapidly changing environment and current health care dynamic climate.
Ability to function well under condition of current environment.
Demonstrated ability to plan, design and implement one's own work and to work independently with minimal observation or supervision.
Ability to lead by example.
Able to meet service excellence for others.
Demonstrated ability to communicate clearly and effectively and to work collaboratively with multiple others of diverse cultures, education background, experience, etc.
Demonstrated knowledge of team building skills and principles of self-managed work teams.
Must demonstrate excellent oral and written communication and interpersonal skills.
Ability to collaborate with others, and to consider conflicting viewpoints.
Ability to build partnerships with physicians and other key stakeholders.

Nice To Haves

leadership experience.

Responsibilities

Provides oversight for the agency's regulatory compliance services, including TJC, CARF, CMS, Title 22 regulations and all other appropriate professional organizations, accrediting bodies and regulatory agencies.
Oversees compliance with regulatory changes.
Directs activities to ensure delivery of high quality, cost-effective care according to patient needs, physician orders, and in compliance with applicable regulations.
Collaborates with the clinical educators and leadership team to assure all staff receives appropriate ongoing education regarding regulatory compliance.
Monitors IRF case mix and resource utilization.
Coordinates the organization of Medical Records to be submitted for review by insurance companies and government agencies.
Ensures all documentation is present in the Medical Records for review, reviews all IRF and OP Rehab denials and follows appeals process to completion.
Provides leadership in the planning, development, coordination and implementation of regulatory compliance activities, including QA, UR and PPS. Includes policies, procedures and processes.
Responsible for the organization of quarterly/yearly outcome reports for IRF. Will ensure clinical managers are educated on the data presented and ensure this data is presented to staff. All data is organized and presented meeting accrediting agency requirements.
Responsible for the oversite of all regulatory requirements for collection and input of data for IRF-PAI to ensure maximum reimbursement. Ensures the timely transmission of patient data to IQIES to avoid any financial penalties.
Oversees the accurate input of patient data in the UDS PRO system; uploading and downloading reportable information to ensure timely benchmarking of data against Regional and National Rehab Facilities.
Collaborate with Marketing regarding the development, marketing, implementation and evaluation of programs.
Participates in administrative strategic planning, staff meetings and attends other meetings as assigned; establishes and maintains communication within the department and with other hospital departments, develops relationships with community agencies, groups, professional affiliations as appropriate; ensures that departments are represented at conferences and working committees.
Assume 24-hour responsibility and accountability of unit(s)/program(s)/discipline department(s), supervised.
Responsible for the selection, training, orientation and assignment of department staff; develops standards of performance and monitors and supervises staff; evaluates performance and initiates or makes recommendations for personnel actions such as merit increases, promotions and disciplinary action; encourages professional development of department personnel through in-service education and outside conferences; develops and maintains job descriptions for all staff members; resolves staff grievances. Maintains professional growth and development.
Assure productivity and quality measures are tracked and maintained. Develops and maintains departmental records, reports and patient records; collects statistical data is required. Develops and recommends department operating budget and ensures that departments operate within allocated funds; maintains department reports and statistics for administrative and regulatory purposes; consults with administration concerning capital expenditures.
Identifies patient needs and ensures development of therapy and business programs to meet these needs; assures the delivery of quality services to inpatients and outpatients; is available for consultation with medical, nursing and administrative staff; manages case load and therapist hours to suit needs of patients and institution. Develops and maintains continuous quality improvement records and processes of the assigned departments; introduces and demonstrates new techniques and equipment to the staff; meets regularly with nursing staff for optimal clinical care delivery. Attain patient satisfaction scores greater that the 90th percentile, as measured by Press-Ganey or the most current system used to measure patient satisfaction as required and appropriate.