PRTF Compliance Inspector, RN

About the Role

Responsible for inspections and assessments to determine Psychiatric Residential Treatment Facilities (PRTFs) adherence to federal and state regulations related to the Inspections of Care (IOC) contract. Collaborates with medical and other professional staff to accomplish goals within designated timeframes. Supports 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 IOC PRTF objectives throughout Arkansas.
• Function as a resource for non-clinical staff by providing oversight and follow-up for clinically related questions or issues.
• Write effective and accurate review summaries and submit within the appropriate timeframe.
• Maintain files for recording and reporting in accordance with established procedures.
• Seek direction from Supervisor for any questions or issues during the review process.
• Participate in the planning, development, implementation, delivery, and evaluation of multiple program activities related to quality of care assessments.
• Communicate effectively with internal and external clients.
• Utilize a project-tracking database to document, collect, and interpret data to meet contractual and reporting requirements.
• Maintain accurate statistical data.
• Maintain a log of all onsite visits, including date, time, location, name, topics covered, feedback received, and recommendations made.
• Complete reports in accordance with contract requirements 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 contract deliverables, policies, and procedures.
• 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

Physical and Sensory Requirements

• Mobility, reaching, bending, lifting, and grasping.
• Ability to read and write, communicate with personnel, and remain calm under stress.
• Ability to 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.

Education

• Diploma or associate degree in nursing.
• Licensed as a Registered Nurse in the state of Arkansas, without restrictions.
• Desirable: Bachelor’s degree in nursing, health care, or 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 of experience in behavioral health, social service, or juvenile justice.
• Desirable: Experience in quality improvement or patient safety.
• Desirable: 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.

Skills and Abilities

• Chart reviewing skills for behavioral health.
• Knowledge of medical necessity criteria.
• Knowledge of 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 presentations.
• Creativity and customer service skills.
• Ability to meet deadlines and attention to detail.
• Flexibility and knowledge of HIT/EHR.
• Understanding of 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.

Internet Requirements

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