Regulatory Compliance Specialist

Job Summary

Aids in managing compliance and/or accreditation standards, laws, rules, and regulations. Supports the resolution of compliance and/or accreditation investigations and follows up with various parties to ensure complete resolution. Manages and administers the Compliance and/or Accreditation Plan(s). Identifies root causes and ensures plans and standards are in place, including developing, educating, and implementing related procedures and policies. Maintains thorough knowledge of compliance and/or accreditation policies, procedures, issues, and trends.

About the Role

Supports audits and investigations of compliance and/or accreditation concerns; performs necessary research, documents findings, and follows up with applicable parties through complete resolution. Collects, collates, monitors, and audits data and activities to ensure accuracy and prevent, detect, and correct non-compliance, illegal activities, and potential or actual fraud, waste, or abuse. Supports regulatory surveyor site visits including preparation and corrective action response.

Essential Functions

• Supports audits and investigations of compliance and/or accreditation concerns; performs necessary research, documents findings, and follows up with applicable parties through complete resolution.
• Colls, collates, monitors, and audits data and activities to ensure accuracy and prevent, detect, and correct non-compliance, illegal activities, and potential or actual fraud, waste, or abuse.
• Supports regulatory surveyor site visits including preparation and corrective action response.
• Exercises administrative judgment and assumes responsibility for decisions, consequences, and results having an impact on people, costs, and quality of service.
• Assists with the development, implementation, and maintenance of process improvement including departmental and/or organizational policies, procedures, and methodologies and medical record design - assuring compliance with laws, regulations, and standards while using accumulated data.
• Reviews and monitors adherence to documented plans and programs including the Code of Excellence.
• Assists in the review of regulatory standards, evaluation of the level of compliance, identification of challenges, proposal of solutions, monitoring of compliance, and management of evidence documents.
• Assists in a variety of projects related to compliance and accreditation. Identifies best practices and researches and evaluates its implementation within our organization. Assists in the development of recommendations and action plans.

Qualifications

• Bachelor's Degree or equivalent in Business, health care operations, nursing, or other related area, or equivalent combination of education and experience.
• 2 years of relevant experience.