What are the responsibilities and job description for the Compliance Specialist 2 - Zone 11 position at Georgia Department of Community Health?
Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and under-served populations. Six enterprise offices support the work of the agency’s three program divisions. DCH employees are based in Atlanta, Cordele and across the state.
DCH is committed to providing superior Customer Service and Communication, embracing Teamwork and fostering Accountability to ensure that our internal and external customers and stakeholders feel included, respected, engaged and secure.
This is a home based position located in the (Southern Region). Note: All applicants must reside in one of the Zone 11 following counties:
- Conducts utilization reviews, peer reviews, evaluation activities and all other reviews on a scheduled basis.
- Coordinates investigations involving noncompliance in facilities, community programs, regulated entity operations and other related programs.
- Coordinates the data management and quality assurance functions.
- Determines compliance with applicable state and/or federal rules and regulations.
- Develops, implements and evaluates the surveillance of utilization review process to ensure quality services.
- Monitors, tracks, and maintain records on compliance.
- Plans and evaluates outcome studies and/or compliance findings.
- Plans, develops, schedules and implements surveys and complaint investigations for licensure or certification of regulated facilities.
- Plans, organizes, and directs the certification/licensing process.
- Recommends programmatic and/or operational changes based on review, audit or survey results.
- Reviews new rules and service site applications.
- Researches and analyzes state codes, federal regulations and industry manuals regarding forms, policies and procedures.
- Reviews applications for accuracy and compliance with guidelines, regulations and laws. Performs investigations and/or audits according to established rules, regulations and other statutes.
Note: Possession of a valid Georgia driver's license, which would enable the applicant to drive in Georgia, and use of a car at work, are required for employees in this job.
PREFERRED QUALIFICATIONS: Preference will be given to candidates, who have a healthcare background and in addition to meeting the qualifications listed above, possess the following:
- Certification(s) and/or Degree in one or more of the related fields
- Experience in the field of home health and/or hospice or hospital, assisted living, private homecare, adult daycare or any licensed healthcare facility
Experience as as a Registered Nurse/LPN, or licensed professional in a healthcare setting.
- Experience as a Registered Nurse/LPN in the field of mental health or Drug Treatment.
- Experience in utilization review and/or quality assurance in a healthcare setting.
- Experience in conducting assessments and evaluations based on regulations, legal requirements and/or recognized accreditation standards.
- Demonstrated ability to produce high quality documentation with attention to detail.
- Strong communication and writing skills.
- Strong organizational and time management skills.
THIS POSITION IS SUBJECT TO CLOSE AT ANY TIME ONCE A SATISFACTORY APPLICANT POOL HAS BEEN IDENTIFIED. APPLICATIONS WITHOUT WORK EXPERIENCE LISTED WILL NOT BE CONSIDERED. CURRENT GEORGIA STATE GOVERNMENT EMPLOYEES WILL BE SUBJECT TO STATE PERSONNEL BOARD (SPB) RULE PROVISIONS. THE POSITION MAY BE FILLED AT A LOWER OR HIGHER POSITION LEVEL.
This position is unclassified and employment is at-will. Candidates for this position are subject to a pre-employment background history and reference check.
For more information about this job and other career opportunities with DCH, please visit our Careers Page: https://www.governmentjobs.com/careers/dchga.
Salary : $61,280