PRTF Compliance Inspector

About the Role

Responsible for assigned inspections for Psychiatric Residential Treatment Facilities (PRTFs), review and reporting activities related to the Inspections of Care (IOC) contract. Collaborate with medical and other professional staff to accomplish goals within designated timeframes. Support the organization’s mission, vision, and values by exhibiting honesty, excellence, accountability, respect, and teamwork.

Responsibilities

• Travel within the state as needed to accomplish required site visits, including extensive travel requiring overnight stays (up to 3-4 nights per week).
• Enter facilities at various times outside regular work hours (evenings or early mornings) to ensure compliance with specific provider regulations.
• Complete CMS-required trainings related to PRTF surveys.
• Conduct annual onsite PRTF surveys to ensure compliance with State and Federal regulations.
• Conduct onsite PRTF complaint investigations as required.
• Collaborate with team members to develop strategies to implement and achieve Inspections of Care PRTF objectives throughout Arkansas.
• Understand and apply appropriate workflows in the performance of IOC activities.
• Participate in the planning, development, implementation, delivery, and evaluation of multiple program activities for each review episode.
• Seek direction from direct supervisor for any survey-related questions or issues during the inspection process.
• Write effective and accurate inspection summaries and submit them within the appropriate timeframe.
• Communicate data, AFMC project goals, performance indicators, and designated timelines to appropriate target audiences.
• Utilize project-tracking database to document, collect, and interpret data to meet contractual and other reporting requirements.
• Maintain accurate statistical data and logs of all IOC visits, including date, time, location, name, topics covered, feedback received, and recommendations made.
• Complete additional documentation and final reports as required by contract for specific provider types.
• Identify, present, and discuss progress and issues relating to focus areas, and suggest solutions to assist in program development.
• Ensure all activities address designated performance goals and are performed within the designated timeframe.
• Maintain knowledge of specific projects, including contracts, deliverables, policies, and procedures.
• Communicate effectively with internal and external clients and represent AFMC at various external functions.
• Adhere to format, content, and style guidelines, ensuring accuracy, consistency, and quality.
• Follow AFMC, state, and federal protocols regarding data confidentiality/security and HIPAA compliance.
• Perform additional duties as assigned.

Requirements

Education

• Bachelor’s degree in Social Science, Health Administration, Health Information Management, Behavioral Health, or a related field.
• Desirable: Certified Professional in Healthcare Quality (CPHQ), Certified in Healthcare Compliance, RHIA/RHIT, or similar credentials relevant to compliance/auditing.

Experience

• Three (3) years in a behavioral health or social service-related setting.
• Desirable: Three (3) years in a clinical healthcare setting or related experience with AR Medicaid programs.
• 3+ years in healthcare compliance, quality, utilization review, health information management, or behavioral health operations; PRTF/under 21 inpatient psych experience strongly preferred.
• Familiarity with PRTF State and Federal licensure requirements.

Physical and Sensory Requirements

• Mobility, reaching, bending, lifting, and grasping.
• Ability to read, write, and communicate with personnel.
• Ability to remain calm under stress and travel as needed.
• Must be able to lift and transport 25 pounds.
• Must be capable of performing the essential job functions of this job, with or without reasonable accommodations.

Skills and Abilities

• Chart reviewing skills for behavioral health.
• Knowledge of medical necessity criteria, restraint/seclusion documentation, and incident review.
• Knowledge of Medicaid rules and regulations.
• Data analysis and sampling.
• Intermediate-level computer skills (Excel, Word, PowerPoint, and Outlook).
• Typing speed of 50 wpm.
• Exceptional skills in business English and spelling.
• Ability to maintain confidentiality.
• Strong oral and written communication skills.
• Ability to compile reports for clinical and regulatory audiences.
• Customer service skills.
• Ability to meet deadlines and attention to detail.
• Flexibility and knowledge of HIT/EHR and medical terminology.
• Ability to work collaboratively and independently to achieve stated goals.
• Initiative and facilitation skills.
• Ability to relate professionally and positively with staff, business partners, customers, and the public.
• Ability to multitask and prioritize.
• Strong organizational and problem-solving skills.
• Professionalism and project management skills.
• Ability to read, interpret, and apply laws, rules, and regulations.
• Knowledge of quality improvement processes and techniques.
• Valid driver’s license and active auto insurance.
• Time management skills.

Additional Information

Reliable, high-speed wireless internet service (Wi-Fi) is required.