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Home Health Compliance RN Field Specialist -DESCRIPTION RN license and 5 years of home health experience requiredWork From Home/Remote OASIS / ICD 10 coding certification a plus Regional travel required as necessary (25%-40%)Join our compliance team as a home health compliance RN field specialist to use your unique skills as a compliance resource for our home health directors. Assist to proactively identify and investigate compliance issues as part of our compliance program. This position reports to the Manager of Corporate Compliance.MAIN DUTIES AND RESPONSIBILITIES (Essential Functions include but are not limited to)
Collaborate with compliance team members to implement the compliance program. Proactively identify systemic issues and recommend solutions to update compliance materials, policies, and standard operating procedures.
Collaborate with compliance team members to oversee timely investigation of compliance incidents. Organize, document, track and resolve compliance issues as they arise. Investigate and manage complaints relating to home health service related and patient care concerns, coordinate appropriate members of the investigative team, facilitate calls with field investigators to review findings and develop investigation plans.
Educate home health directors and employees on ways to recognize, prevent, report, and resolve instances of conflict of interest, medical record documentation errors involving fraud, waste, and abuse, HIPAA privacy violations, and other compliance concerns in the home healthcare environment.
Serve as compliance resource to home health directors, clinical, and employee relations teams for HIPAA privacy officer designee program reporting, survey tracking, annual training, and regulatory concerns.
Conduct focus audits to monitor compliance with laws and regulations, policies and procedures as indicated. Assist in compiling trends for QAPI and continuous improvement to identify systemic issues.
Assist in development of compliance learning materials for home health and provide compliance educational offerings; provide webinars and in-services as needed. Monitor and track completion of training and other compliance requirements.
Monitor industry regulatory changes and distribute related communications. Access internal resources for information on compliance with laws and regulations relating to new or revised products and service offerings.
REQUIRED QUALIFICATIONS
Active Registered Nurse (R.N. license)
Minimum 5 years’ experience in a home health environment
HCHB experience
Knowledge of industry standards for Medicare, Medicaid, and regulatory standards for home health and licensed agency services
Experience conducting compliance investigations, preferably in health care setting
Experience in auditing and monitoring, including focused chart reviews, data analysis
The ideal candidate should have excellent organizational skills and be detail oriented
Meeting facilitation and presentation skills
Excellent analytical, written and oral communication, and project management skills
Experience in compliance and HIPAA privacy regulations, policies and processes
Knowledge and technical proficiency with Microsoft Office applications to include Word, Excel spreadsheets, and PowerPoint.
PREFERRED QUALIFICATIONS
Certifications in OASIS, ICD-10 coding
Bachelor degree in nursing, health care administration, or related health care field
HCCA Health Care Compliance Association membership
