Compliance Risk Specialist

Bethesda Brings out the Best in Talented, Caring People At Bethesda, more than 1,200 employees dedicate their careers to improving the lives of others.

As a team member at Bethesda, you'll enjoy great benefits such as: 403b, daily pay, bonuses, career advancement opportunities, and holiday pay.
Medical, dental, vision, prescription, and life insurance available for regular status full and part time employees.

Summary

Responsible for compliance and risk assessment and coordination in the assigned facility. Responsible for compliance and risk matters in all Bethesda Health Group facilities, including, but not limited to, long term care, independent living, hospice, home care and assisted living. Serves as a resource for all levels of staff for any compliance or risk related matter. Conducts various internal audits in accordance with an annual schedule of compliance matters including but not limited to medical documentation to support claims billed, audits of medical records, employee records and other documents to maintain compliance with regulatory requirements. Prepares written reports for facility leadership and presents findings to the appropriate leader and at the facility's quality improvement meetings. Performs focused audits as requested and as determined by facility administration, operations and/or the compliance department. Audits third party vendors and agencies for compliance with regulations and laws. Performs mock surveys for the facilities in assisting in preparing for annual surveys. Performs audits as noted above in areas identified as high risk for tags on annual and complaint surveys. Supports the facility during the annual survey and as needed on complaint surveys. Assists with corrective action plans as needed. Tracks and trends adverse outcomes and high-risk areas for injuries. Investigates all serious events and documents findings in an appropriate manner. Responds to facility as needed to assist with investigations of serious events. Drafts confidential reports in anticipation of litigation. Encourages reporting of events and a culture of safety without fear of retaliation. Documents all potential claims and assists with gathering information in response to litigation matters maintaining confidentiality of all discussions and documentation. Works with leadership in identification of risk issues and risk reduction. Takes call from facility administrator and director of nursing after hours and on weekends. Supports and provides direction to medical records in compliance related matters including proper release and storage of medical records in compliance with the privacy laws. Supports and provides direction to social services role in discharge and documentation. Provides compliance and risk education and training to various departments upon request and as needed. Assists in developing and implementing compliance and risk policies and procedures. May be assigned other duties as appropriate.

• Registered Nurse, bachelor's degree preferred
• Nursing license in Missouri and Illinois
• Two years of long term care experience with at least one year as MDS Coordinator
• Acute care highly desirable
• Knowledge of Medicare and Medicaid required
• Experience training/teaching adults preferred
• Software skills in Word, Excel, PowerPoint, or equivalent required
• Basic knowledge of and experience utilizing a personal computer
• Verbal and written communication skills
• Excellent interpersonal and organizational skills
• Manual dexterity, coordination and skillful use of hands for working with required equipment
• Ability to receive and express detailed information through oral communication
• Visual acuity and the ability to read and understand written directions
• Requires frequent travel to/from residences and services, sitting, standing, walking, stooping and bending required
• Occasional hours of work required other than regular business hours