Regulatory Licensing Specialist

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters.

About the role

This job is responsible for licensing and certification processes and Centers for Medicare and Medicaid Services (CMS) time study administration for the organization. The role involves timely completion of annual license renewals for all facilities, managing the completion of several licensing projects concurrently to meet required standards and deadlines, and maintaining Medicare certifications/enrollments and Medicaid enrollments for all facilities. In addition, this position performs regulatory and compliance-related research.

Responsibilities

• Timely completion of annual hospital and facility license renewals for the system, including tracking expiration dates and collecting onsite inspection reports to ensure new licenses are obtained, and ensures facility compliance with state-specific licensing standards and federal regulations.
• Remains knowledgeable on current federal and state regulations.
• Manages several licensing projects concurrently and ensures projects meet required standards and assigned deadlines.
• Works with project stakeholders and external cohorts to collect required documents and information to complete licensing packets; communicates effectively and timely with key stakeholders about projects to resolve issues and meet deadlines.
• Facilitates project management meetings and ad hoc meetings, documents meeting notes, and completes related action items.
• Coordinates onsite physical environment surveys, preparing clinical and operational teams to ensure survey readiness, and reporting onsite to act as licensing lead during those onsite surveys.
• Applies for initial Medicare and Medicaid enrollments for new hospitals, facilities, and provider types.
• Maintains existing Medicare and Medicaid enrollments, updates and revalidates enrollments as needed or as required by CMS; utilizes PECOS (Provider Enrollment, Chain, and Ownership System) database to submit new enrollment applications and to update existing enrollments.
• Administers CMS Physician Time Study, which occurs 2 weeks per quarter, for a total of approximately 2,000 physicians. That includes updating the online database with participant information, maintaining instructions and training tools, conducting group and individual training sessions, monitoring and encouraging timely submission from all participants, performing quality audits of submitted time studies, and preparing quarterly and annual reports.
• Administers CMS Lay Transplant Time Study, which occurs 1 week per month, for approximately 200 participants. That includes updating the online database with participant information, maintaining instructions and training tools, conducting group and individual training sessions, monitoring and encouraging timely submission from all participants, and preparing monthly and annual reports.
• Performs regulatory and compliance-related research.
• Remains knowledgeable on current federal, state, and local laws, accreditation standards, or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations, and standards.
• Performs other related duties as required.

Requirements

• Bachelor's degree in healthcare or related field (required).
• Master’s degree in healthcare or related field (preferred).
• 2 years in healthcare compliance, licensing and certification, operations, regulatory compliance, risk management, audit, law, or related field (required).
• Experience with healthcare licensing and certification or healthcare corporate compliance issues (preferred).

Qualifications

• Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Certified in Healthcare Research Compliance (CHRC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS) (preferred).

Skills

• Strong analytical and attention to detail skills.
• Highly effective verbal and written communication skills.
• Strong organizational and prioritization skills.
• Ability to gather information and understand problems to identify underlying issues.
• Strong interpersonal and team-building skills.
• Proficiency in Outlook, Microsoft Word, moderate-level Microsoft Excel, PowerPoint, Adobe, and other software/web-based applications.
• Ability to facilitate meetings and presentations to large groups.
• Ability to work under minimal supervision.
• Ability to travel regionally to various locations (Lafayette, Shreveport/Monroe, Baton Rouge, Houma, New Orleans, Chalmette, etc.).

Physical and Environmental Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects.
• Normal routine involves no exposure to blood, body fluid, or tissue, and incumbents are not called upon to perform or assist in emergency care or first aid.
• The incumbent has no occupational risk for exposure to communicable diseases.
• There may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning, and/or disposal of contaminated waste.