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Director Clinical Compliance RN
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HCA Healthcare
Nashville, TN (In Person)
Full-Time
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Job Description
Introduction Do you want to join an organization that invests in you as a Director Clinical Compliance RN? At HCA, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Benefits At HCA, we want to ensure your needs are met. We offer eligible colleagues an attractive benefit package that includes medical, wellbeing, dental and vision benefits along with some unique benefits including: Medical, Dental, Vision, Life Insurance and Flexible Spending Paid Time Off (PTO) and Personal Leave 401K (100% annual match - 3% to 9% of pay based on years of service) Academic Assistance and Reimbursements for Tuition and Student Loans Employee Discounts including Tickets, Retail, Mental Health Apps, Education Apps, Identity Theft Protection etc. Home, Auto, and Pet Insurance Employee Stock Purchase Program (ESPP) Short Term & Long Term Disability coverage Adoption Assistance Legal Benefits and lots more! You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Director Clinical Compliance RN like you to be a part of our team. Job Summary and Qualifications One of the nation's leading provider of healthcare services, HCA Healthcare is made up of locally managed facilities that include approximately 300 hospitals and freestanding surgery centers in 20 U.S. states and in the United Kingdom. HCA Healthcare employees approximately 250,000 people and approximately 4-5% of all inpatient care delivered in the country today is provided by HCA Healthcare facilities. HCA Healthcare is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve. The Internal Audit Department provides an independent appraisal function to validate management control systems and to support corporate management in the effective discharge of their responsibilities and efforts to achieve the Company's overall mission. The Clinical Compliance Team test work includes a variety of audits which tests the medical records and corresponding bills to ensure compliance with company policies and government regulations. The purpose of the audit is to assist facility management in determining compliance with company-defined processes and CMS requirements. The team works closely with facility, division, and group management as well as corporate responsible personnel to help effect overall compliance The Clinical Compliance Director position will work on various audit engagements with team members at various levels and will receive a formal evaluation yearly. What you will do in this role: Directs and coordinates clinical compliance team reviews. Oversees reviews of hospital/center systems to ensure compliance with applicable legal, regulatory and licensure requirements as defined by CMS, state regulations, and company policy. Reviews detailed reports specifying compliance issues identified during the audit. Demonstrates a thorough understanding of CMS, Joint Commission, and State Health Department regulations, regarding post-acute services, admission status, licensure/certification, clinical trials, core measures, National Coverage Determination requirements, and other review areas. Participates in the audit quality assurance program. Serves as a mentor to Senior Manager/Manager personnel to help them reach their full potential - including conducting meaningful and annual performance reviews, serving as a positive role model, and assisting them in designing and implementing individual career development plans. Understands HCA Healthcare's business and the healthcare industry from a global perspective by recognizing business trends and emerging technical and industry developments of relevance and communicates these to the client engagement team and applicable management personnel. Serves as a trusted business advisor by providing client management value-added advice. Provides input and guidance in the development of, as well as the review of the detailed audit/review programs particularly focusing on complex audit issues. Demonstrates working knowledge of Medicare rules and regulations and stays abreast of regulatory changes. Presents quarterly/annual updates to members of the Executive Management Team of HCA Healthcare. Provides ongoing consultation for facility, Division, and Group management. Approves executive summaries and audit reports, identifying the key issues for discussion with facility, Division, and Group management. Stays abreast of company-wide initiatives and effectively evaluates impact on the planned audit approach. Utilizes and encourages the use of computer-based tools to continually develop innovative audit approaches and enhance internal audit services. Develops strategies to improve audit effectiveness and efficiency and proposes modifications to current procedures. Recommends and helps implement management decisions for the department. Leads efforts related to other educational and administrative matters (e.g. professional development programs, process improvement team initiatives, recruiting efforts, and special projects).