Sheriff Health Compliance Manager

Sheriff Health Compliance Manager Merced, CA Job Details Full-time $56.69 - $68.99 an hour 1 day ago Qualifications Statistics Contract management Clinical program implementation Utilization review Accreditation standards (regulatory compliance area) RN License Correctional experience Data reporting Research Mid-level Contract management in healthcare Drug therapy monitoring Supplier audit compliance assessment Quality assurance audits Driver's License Policy & process development Case management Corrections facility medical clinic experience Quality improvement Contracts Vendor contract management Healthcare policy development Quality audits Contract negotiation 1 year Care coordination Healthcare compliance Documentation review Full Job Description JOB Duties may include, but are not limited to the following: Provides consultation to the Sheriff's Office and contracted program staff on QA/QI issues. Monitors quality improvement for the jail medical and behavioral services contract, including creating and monitoring the quality improvement work plan and QI committee. Assists the Department in preparation for various audits, including legally mandated External Quality Review (Remedial Plan) and Medi-Cal County Inmate Enrollment Program (MCIEP) oversight review. Reviews and analyzes data and findings from internal program reviews and external audits to identify problem areas and makes recommendations for improvement. Maintains and compiles statistical reports related to legally mandated External Quality Review (Remedial Plan); identifies new components or activities required by the Remedial Plan.

Develops, implements, and maintains infrastructure and procedural systems to track and improve outcomes, quality monitoring activities, business processes and care for incarcerated persons.

Assists in the development and implementation of clinical processes, including medication monitoring and peer/supervisory review; oversees QI work plan activities, performance improvement projects, and contract management. Consults with the Sheriff's Office administration regarding program needs, policies, and procedures, and prepares plans to ensure quality medical care and organizational efficiency.

Conducts utilization and quality assurance reviews of medical records to ensure appropriate care and case management services. Reviews and assesses complex cases to ensure appropriate care and coordination of services to incarcerated persons.

Reviews grievances and audits all records regarding the delivery of health care services to ensure contracted vendor compliance. Serves as liaison between medical staff and department executive management. May prepare and/or supervise the preparation of reports, correspondence, special studies, and research.

Plan, negotiate and monitor agreements and contracts with plan care and review providers.

Initiate, develop and revise written policies and procedures for the compliance program.

Work with Sheriff Correction's Compliance Unit to closely monitor and review critical incidents involving the medical contractor inside the correctional facilities.

Ensure medical contractor facilitation of required facility accreditations including Board of State and Community Corrections, Public Health, Behavioral Health and National Commission on Correction Health Care.

EXAMPLE OF DUTIES

Experience:

Four (4) years of full-time, paid work experience as a Registered Nurse, one (1) year of which must have involved experience in quality improvement, medical audits, medical record/chart review in a healthcare setting or one (1) year of correctional nursing experience.

License:

Valid Registered Nurse license issued by the State of California, Department of Consumer Affairs, Board of Registered Nursing.

Possess and maintain a valid California driver's license.

SUBJECT TO CRIMINAL HISTORY BACKGROUND CHECK PURSUANT TO THE HUMAN RESOURCES RULES AND REGULATIONS, SECTION 2,B.

Desirable qualifications: Certified Correctional Health Professional (CCHP) certification offered by the National Commission of Correctional Health Care (NCCHC).