Compliance Clinical Specialist

Compliance Clinical Specialist Eagle, ID Job Details 9 hours ago Qualifications CPHQ Collaborate with healthcare professionals Statistics Compliance risk assessment Skilled nursing facility experience Medicare RN License Audit report preparation Hospice experience 5 years Regulatory compliance Compliance audits & assessments HIPAA Corrective and preventive actions (CAPA) Implementing healthcare compliance training programs Microsoft Office RN experience Analysis skills Clinical staff training Decision making Staff training Investigative reports Senior level Communication skills Nursing Post-acute care experience

Analytics Full Job Description Description:

Support ethical, compliant, and high-quality clinical and regulatory practices across a multifacility organization. We are seeking an experienced and dynamic Compliance Clinical Specialist to join our Compliance team. This role partners closely with clinical, operational, and leadership teams to support regulatory compliance, quality outcomes, and ethical business practices across skilled nursing facilities (SNFs), assisted living facilities (ALFs), and Hospice agencies. The position requires regular travel and a field-driven, hands-on, focused hybrid approach to compliance. About You You are a licensed Registered Nurse with clinical experience in skilled nursing or post-acute care environments and a strong working knowledge of regulatory and compliance requirements. You thrive in a compliance role, partnering with operations and the field to identify risk, provide guidance, and drive sustainable, compliant practices. You bring credibility, integrity, and a solution-oriented mindset to complex regulatory challenges. What You'll Do Compliance Audits & Investigations Conduct compliance audits and investigations related to clinical care, documentation, billing practices, HIPAA, and other identified risk areas or regulatory concerns Utilize analytical review, computer auditing tools, and statistical sampling methods Prepare clear, timely audit and investigation reports Follow up on corrective action plans (CAPs) to ensure regulatory compliance Regulatory Guidance & Education Provide regulatory guidance related to nursing practice and clinical compliance requirements Conduct training and education for field teams, leadership, and internal resources Present compliance findings in a clear, practical, and understandable manner Program Development & Risk Management Assist the Chief Compliance Officer with development, implementation, and evaluation of audit tools and compliance program effectiveness Participate in onsite and remote audits, investigations, meetings, and risk assessments Support compliance efforts related to new acquisitions Keep facilities and leadership informed of regulatory changes, audit outcomes, and investigation findings Collaboration & Field Partnership Partner closely with operations and clinical leadership to support compliance, quality of care, and organizational outcomes Attend company and local meetings as requested Provide hands-on compliance support in a fast-paced, highly regulated environment Why Join Us Make a meaningful impact on organizational compliance and clinical quality Partner closely with clinical and operational leaders across the organization Support ethical growth and strong regulatory foundations Influence compliance practices across a multifacility, multistate platform

Requirements:

What You Need to Apply Education & Licensure Active, unrestricted Registered Nurse (RN) license Experience Minimum of five (5) years of clinical nursing experience in a Skilled Nursing Facility (SNF) or post-acute care setting Experience with Medicare Part A and Part B and other payors in multifacility or multistate environments Ability to work with all levels of staff and leadership on complex regulatory issues Prior compliance or quality experience preferred Certifications (Preferred) Certified Professional in Healthcare Quality (CPHQ) Key Competencies Strong analytical and critical decision-making skills Excellent written and verbal communication skills High degree of credibility, integrity, and professionalism Ability to work independently in a home office environment Strong interpersonal skills and ability to build trust with the field Proficiency with Microsoft 365 tools Ability and willingness to travel approximately 60% of the time with overnight travel expected