Compliance Specialist - Zone 2

 

The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and Healthcare Facility Regulation, impacting one in four Georgians.

 

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.  

DCH is currently seeking qualified applicants for the position of Compliance Specialist 2, Long-term Care Unit with Healthcare Facility Regulation Division.  This position spends an average of four days per week in nursing homes conducting regional survey inspections.

This position will document and conduct on-site surveys and require regional travel.  
Regional travel may require up to 90% overnight travel. Occasional weekend and after-hours work may also be required. Under broad supervision, assists in the operations of a unit, developing and administering policy, procedures & plans, and performs special projects as delegated. Conduct investigations to obtain evidence of reported fraud, abuse, or violation of rules, regulations, or statutes, or locate missing persons. May supervise subordinate staff.

• 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.

Master's degree in a related field from an accredited college or university;  OR Bachelor's degree in a related field from an accredited college or university AND Two years of related experience;  OR Associate's degree in a related field from an accredited college or university AND Three years of related experience;  OR Four years of related professional experience.

Note: Some positions may require a certification or licensure.
Note: Some positions may require a valid driver's license.

Note: After hire, this position is required to successfully complete all preparatory training provided, including successful completion of the Surveyor Minimum Qualifications Test within the first 12 months of employment as required by Sections 1819(g) (2) (C) (ii) of the Social Security Act, as amended, and Article IV (B) of the Agreement pursuant to Section 1864 of the Social Security Act.  Upon successful completion of the SMQT, this position is eligible for a pay increase. 

PREFERRED QUALIFICATIONS:  Preference will be given to candidates, who in addition to meeting the qualifications listed above, possess the following:

• Four years of related experience administering and monitoring the compliance of healthcare programs
• Advanced degree in health related, healthcare administration or business related field
• Significant experience developing and implementing program policy
• Experience in monitoring budgets and producing reports for government entities
• Experience as licensed healthcare professional (RN, LPN, CNA, PCT)
• Working knowledge and experience using computer programs related to healthcare.

EARN MORE THAN A SALARY!  In addition to a competitive salary, the Georgia Department of Community Health offers a generous benefits package, which includes employee retirement plan; paid holidays annually; vacation and sick leave; health, dental, vision, legal, disability, accidental death and dismemberment, health and child care spending account.

 

Due to the volume of applications received, we are unable to provide information on application status by phone or e-mail. All qualified applicants will be considered, but may not necessarily receive an interview. Selected applicants will be contacted by the hiring agency for next steps in the selection process. Applicants who are not selected will not receive notification. 

 

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