Medical Compliance Specialist

1 week ago

Bellevue, Washington, United States Redwood Family Care Network Full time

Job Summary

We are seeking a highly skilled Medical Compliance Specialist to join our team at Redwood Family Care Network. In this role, you will be responsible for ensuring compliance with regulatory requirements and providing support to the interdisciplinary team.

Responsibilities:

  • Monitor medical coordination for individuals with intellectual and developmental disabilities.
  • Develop and maintain expert knowledge of regulatory requirements pertaining to medical needs, guidelines, laws, etc. in the supported living field.
  • Re-train DSPs as needed when medical errors occur or trends are noted.
  • Communicate with the Nurse Delegation Team, DDA, and medical professionals regarding individual care.
  • Investigate all incident reports involving clients, interview staff to collect necessary documentation, create a detailed report, and schedule a meeting with the Regional Director and Director of the department.
  • Generate reports and provide recommendations during leadership meetings in regards to incident reports and/or behaviors.
  • Manage Nurse Delegation by ensuring clients requiring delegated tasks are scheduled for required visits, documentation is received and up to date, and that ample qualified staff are delegated to complete delegated tasks.
  • Maintain medical records as required by regulatory guidelines.
  • Report suspicions of abuse/neglect/exploitation per guidelines.
  • Complete and remain current in First Aid, CPR, Therapeutic Options, Infection Control, and Bloodborne Pathogens Training.
  • Monitor health needs, including medications, special diets, and notify supervisors of any outstanding needs.
  • Attend Supervisor meetings, chaired by the WA Residential Director, to review medical matters pertaining to the facilities/clients as requested.
  • Provide Lift and Transfer assistance training, requiring the ability to bear and maneuver up to 50 or more pounds of unbalanced weight.
  • Work with the WA Residential Director to respond to corrective action in regards to medical compliance within required time frames.
  • Ensure each facility has the needed medical documentation and forms.
  • Ensure each facility has updated and relevant medical and medication protocols and provides staff training as needed.
  • Regularly review on-site medications and medical documentation.
  • Upload medical documentation into client files within one week of completion.
  • Communicate with Client Guardians and Case Managers as needed regarding medical appointments, medication changes, and needed procedures.
  • Work with the WA Compliance Director to ensure compliance with all required dates: Medical appointments, consent forms, etc.
  • Check in cycle medications, record, and implement medication changes in the facilities.
  • Coordinate with supervisors to ensure medical appointments are being completed and that medical documentation is being completed properly.
  • Attend appointments as needed for new client PCP set up, mental health, or behavioral needs.
  • Enter scheduled client appointments into tracking systems.
  • Attend medical appointments as needed for clients with high medical needs.
  • Scan appointment information to third parties as requested.
  • Coordinate with the WA Compliance Director to conduct one full medical QA monthly for each facility.
  • Provide disciplinary action with staff and program supervisors as needed for documentation, cleanliness of homes, and overall compliance in regards to medical concerns.
  • Set up new client pharmacy agreements, personal care supplies, medical appointments, dental appointments, and mental and/or behavioral health appointments.
  • Record and maintain client information such as personal data in databases and files.
  • Schedule nurse delegation for staff identified as needing it by Program Supervisors, ensure proper documentation for nurse delegation is completed and on-site.
  • Monitor required dates for upcoming medical appointments, care plans, and consents.
  • Create and modify documentation forms for clients as needed for medical tracking.
  • Review medical documentation to ensure follow-ups are scheduled and treatment plans are completed prior to filing in client retention.
  • Review client plans for accuracy regarding medications, medical support needs, and hygiene support needs.
  • Ensure clients have needed hygiene supplies by setting up accounts and ensuring staff know how and when to order supplies as needed.
  • Manage all MARS between the pharmacy and within our database as needed.
  • Work with Directors to ensure COVID response plans are being followed for the whole company.
  • Manage COVID reporting to state and local health departments for all departments.
  • Ensure staff credentials are emailed or faxed to nurse delegators for all departments.
  • Ensure nurse delegation information is up to date and accurate in client homes for all departments.
  • Monitor client dates for expiring care plans, consents, and medication treatment for all departments.
  • Preferred Qualifications
    • Identifying potential areas of compliance vulnerability and risk, developing/implementing corrective action plans.
    • Providing general guidance on how to avoid or deal with similar situations in the future.
    • Experience with medications and medical information for vulnerable populations.
    • Ability to act as an independent review and evaluation body to ensure compliance issues/concerns within the organization are being appropriately evaluated, investigated, and resolved.
    • Building great working relationships with employees and communicate effectively.
    • Writing reports, business correspondence, and procedure manuals.
    • Calm under pressure, multitasking, self-directed, and frequent interruptions.
  • Benefits
    • Competitive salary: $65,000 - $85,000 per year.
    • Medical, Vision, and Dental Insurance.
    • Voluntary Short-term and Long-term Disability.
    • Accident, Critical Illness, and Hospital Indemnity.
    • Employee Assistance Program.
    • Basic Life Insurance & ADD.
    • Voluntary Life Insurance.
    • Paid Time Off (PTO Vacation & Sick Time).
    • Peer Referral Program.
    • Payday on demand through Dayforce Wallet.
    • Working Advantage employee discount program.
    • Health Savings Account (HSA).
    • Flexible Savings Account (FSA).
    • 401(K).
    • Capella University Discount.

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