Progam Manager RN, Compliance-Care Delivery - Rockville Regional Office
This position provides guidance and recommendations on clinical care compliance. The position will consult with and provide advice to internal clients in the development of compliance policies, procedures and workflows in support of National and MAS clinical initiatives. This position works in collaboration with regional functions, with the National Compliance Office, and in partnership with MAPMG compliance to provide analysis of issues and risks, and to conduct compliance investigations.
Works with Compliance leadership to communicate with regional leaders and managers regarding oversight activities across regional work teams and processes. Supports interdepartmental communication and coordination of Compliance issues and activities. Serves as liaison between the regional compliance office and the health care delivery system committees which address compliance issues.
Conducts, oversee and/or participates in clinical area risk assessments and audits within the region to measure compliance with state, and federal laws and accreditation requirements. Is responsible for project tracking, analysis, and identification of deficiencies necessary to correct in order to achieve compliance with standards. Partners with AR&L team in Quality to support clinical accreditation and licensure of facilities and depts.
Conducts investigations which relate to clinical compliance concerns, in partnership with other compliance and human resources staff, and may be required to support other regional compliance investigations on an ad hoc basis.
Assists and partners with appropriate Regional departments/functions and individuals to maintain clinical protocols, policies and procedures compliant with the relevant state federal, accrediting and KP regional and national policy requirements.
Works with Compliance leadership to monitor and evaluate regional clinical departments'/functions' compliance with law, standards, policies and procedures, working closely with Legal and Operational areas.
Creates, implements and maintains materials related to compliance awareness infrastructure including communications, web presence and training course.
Minimum of three (3) years of experience in healthcare organization required.
Minimum of two (2) years working with clinical staff.
Bachelor's Degree in compliance, law, business or healthcare related discipline.
License, Certification, Registration
Current RN Licensure in good standing in District of Columbia, Maryland (or compact state) or Virginia (or compact state) required.
Excellent written and oral skills; and effective time management experience required.
Writing samples will be required from all final candidates.
Ability to conduct and manage complex or sensitive investigations and interviews in a professional and comprehensive manner is required.
Ability to manage complex reporting structures required.
Experience in collection, maintenance, display and analysis of data is required.
Knowledge of office procedures and use of Microsoft Office including Word, intermediate Excel, and Power Point required.
Ability to manage multiple priorities and projects and meet deadlines required.
Demonstrated ability to work independently and to motivate people to achieve shared goals is required.
Results-oriented, analytical and creative thinker with the highest level of personal integrity required.
Strong attention to detail is mandatory for success in this role required.
Significant experience in managing large and complex projects required.
Significant experience with health care codes and regulation research, interpretation and implementation required.
Prior experience with **MEMBERS ONLY**SIGN UP NOW***. preferred.
Familiarity with coding and documentation principles preferred.
Experience with Virginia, Maryland or DC regulations, Medicaid and Medicare standards are preferred.
Master's Degree in compliance, law, business or healthcare related discipline preferred.
Maryland,Rockville,Rockville Regional Offices 2101 E. Jefferson St.
Scheduled Weekly Hours:
Mon - Fri
Working Hours Start:
Working Hours End:
Employee Group/Union Affiliation:
Salaried, Non-Union, Exempt
Compliance / Privacy / Regulatory
Yes, 5 % of the Time
**MEMBERS ONLY**SIGN UP NOW***. is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.