Job Summary
Assists with management of compliance and/or accreditation standards, laws, rules and regulations related to the clinical environment. Supports the resolution of compliance and/or accreditation investigations in the clinical environment and follows up with various parties to assure complete resolution. Supports the management and administration of the Compliance and/or Accreditation Plan(s). Identifies root causes and assures plans and standards are in place including development, education and implementation of related procedures and policies in the clinical environment. Maintains thorough knowledge of compliance and/or accreditation policies, procedures, issues, and trends.
Essential Functions
Supports audits and investigations of compliance and/or accreditation concerns related to the clinical environment; performs necessary research, documents findings, and follows up with applicable parties through complete resolution. Collects, collates, monitors and audits data and activities in the clinical environment to assure accuracy and to prevent, detect and correct non-compliance, illegal activities, and potential or actual fraud, waste or abuse. Supports regulatory surveyor site visits including preparation and corrective action response. From time to time, performs investigations at the direction of legal counsel and works with legal counsel in the course of such investigation to provide guidance, recommendations and other assistance as requested by legal counsel. In such cases, the employee will report directly to legal counsel as opposed to employee's up-line leadership, and such work with legal counsel shall be confidential and protected from disclosure by the attorney client privilege and work product protection.
Exercises administrative judgment and assumes responsibility for decisions, consequences and results having an impact on people, costs, and quality of service. Assists with the development, implementation and maintenance of process improvement including departmental and/or organizational policies, procedures and methodologies and medical record design - assuring compliance with laws, regulations and standards while using accumulated data. Reviews and monitors adherence to documented plans and programs including the Code of Excellence. Assists in the review of clinical regulatory standards, evaluation of the level of compliance, identification of challenges, proposal of solutions, monitoring of compliance and management of evidence documents. Assists with continuous readiness activities.
Collaborates with operational and other areas in investigations and to implement ongoing risk identification and mitigation measures related to the clinical environment. Proactively consults with operational areas and leadership through both formal (meetings, education) and informal means.
Maintains knowledge of laws, regulations and standards impacting healthcare delivery and reimbursement. Applies laws, regulations and standards in daily situations while educating others through various means including formal training and education. Performs or supports related assessments to assure compliance to laws, regulations, standards and policies and procedures.
Assists in a variety of projects related to compliance and accreditation related to the clinical environment. Identifies best practices and research and evaluates its implementation within our organization. Assists in the development of recommendations and action plans. Maintains attention to detail, documents details appropriately, and effectively articulates recommendations and outcomes both verbally and in writing in both small and large group forums.
Qualifications
Required Bachelor's Degree or equivalent Business, health care operations, nursing or other related area, or equivalent combination of education and experience
2 years of relevant experience Related Experience Required
Clinical Background Required
Working in a organization of size and complexity of Corewell Health Preferred
LIC-Registered Nurse (RN) - STATE_MI State of Michigan required
CRT-Healthcare Compliance, Certified (CHC) - HCCA Health Care Compliance Association preferred
Physical Demands
Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs
Waist to Waist > 5 lbs: Seldom up to 10 lbs
Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
Waist to Overhead > 5 lbs: Seldom up to 10 lbs
Bilateral Carry > 5 lbs: Seldom up to 10 lbs
Unilateral Carry > 5 lbs: Seldom up to 10 lbs
Pushing Force > 5 lbs: Seldom up to 10 lbs
Pulling Force > 5 lbs: Seldom up to 10 lbs
Sitting: Frequently
Standing: Occasionally
Walking: Occasionally
Forward Bend - Standing: Occasionally
Forward Bend - Sitting: Occasionally
Trunk Rotation - Standing: Occasionally
Trunk Rotation - Sitting: Occasionally
Stair Climbing: Seldom
Driving: Occasionally
Reach - Above Shoulder: Occasionally
Reach - at Shoulder or Below: Occasionally
Handling: Occasionally
Forceful Grip > 5 lbs: Seldom
Forceful Pinch > 2 lbs: Seldom
Finger/Hand Dexterity: Frequently
Primary Location
SITE - 320 Michigan St - Grand Rapids
Department Name
System Compliance
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8
Days Worked
Monday - Friday
Weekend Frequency
N/A
CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.
People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people-including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities-and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.