Compliance RN - Registered Nurse

Compass Healthcare Consulting & Placement is conducting a search for a Compliance RN for a large Healthcare Organization with offices located in Manhattan, NY. Qualified candidates will have proven experience as an RN in Compliance, comfortable with Designing, Developing, Auditing and Monitoring data related to Clinical Compliance. Related experience includes Quality Management, Performance Improvement and Utilization Management positions within Home Care or Managed Care Plans.
Job Responsibilities:

Under the direction of the Compliance Officer and working closely with members of the Clinical Leadership, the Compliance RN is responsible for designing, planning and executing compliance audits to satisfy the requirements of the compliance program.

• Plans and develops Compliance audit plan for the agency and affiliated business units in conjunction with the Compliance Officer/Compliance Committee/business unit administration.

• Designs and develops auditing/monitoring metrics and methodologies for evaluation of identified risk areas, regulatory and compliance industry standards.

• Conducts scheduled, unscheduled, and ad hoc audits.

• Performs follow up audits/monitoring activities to ensure and validate satisfactory implementation of corrective action plans (CAP) by the business unit/department.

• Collaborates with Compliance Officer/department to conduct necessary follow-up on compliance matters (investigations, allegations of non-compliance, privacy breaches, hotline calls, medical record requests, external audits, etc.) to maintain accurate documentation and record keeping ensuring satisfactory completion of tasks.

• Participates in and/or conducts various committees, meetings and educational trainings as directed by Compliance Officer (including but not limited to Compliance Committees, QICs, root cause analysis, staff education activities, etc.).

• Performs tracking and trending of compliance data and statistics to capture effectiveness of compliance program.

• Educates employees and staff in regulatory and compliance information.

Qualifications:

Bachelor's Degree required with Master’s Degree (completed or in progress) in a health-related field (RN required)

Five or more years’ experience in compliance-related matters of the health care industry, with keen auditing skills

Ability to understand and interpret clinical documentation in patient medical record

Proficient and experienced with a strong working knowledge and interpretation of regulations and/or industry guidance of clinical, finance, reimbursement, coding, etc., matters related to compliance

Certification in Healthcare Compliance (CHC) is highly recommended
Competitive Salary & Benefits Package!
Qualified Candidates Please Apply Now for Immediate Consideration