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Description

Introduction

Do you want to join an organization that invests in you as a Senior Manager Clinical Compliance and Regulatory Accreditation? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Benefits

HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

+ Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.

+ Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.

+ Free counseling services and resources for emotional, physical and financial wellbeing

+ 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)

+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock

+ Family support through fertility and family building benefits with Progyny and adoption assistance.

+ Referral services for child, elder and pet care, home and auto repair, event planning and more

+ Consumer discounts through Abenity and Consumer Discounts

+ Retirement readiness, rollover assistance services and preferred banking partnerships

+ Education assistance (tuition, student loan, certification support, dependent scholarships)

+ Colleague recognition program

+ Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

+ Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

_Note: Eligibility for benefits may vary by location._

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Senior Manager Clinical Compliance and Regulatory Accreditation like you to be a part of our team.

Job Summary and Qualifications

The Internal Audit Department provides an independent appraisal function to validate management control systems and to support corporate management in the effective discharge of their responsibilities and efforts to achieve the Company's overall mission. The Clinical Compliance Team’s work includes a variety of audits and performs onsite and/or remote assessments of focused areas within HCA Healthcare hospitals which include maintaining accreditation (i.e., The Joint Commission (TJC)), federal, state, and local regulations, emergency services, nursing services, etc. Audits also include testing of medical record documentation and corresponding bills to ensure compliance with company policies and government regulations. The purpose of the audits is to assist facility management in determining compliance with company-defined processes and CMS requirements. The team works closely with facility, division, and group management as well as corporate responsible personnel to help effect overall compliance. As the Clinical Compliance Audit Manager, you will work on various audit engagements with team members at various levels and receive formal evaluations twice a year.

CORE JOB RESPONSIBILITIES

+ Demonstrates a thorough understanding of The Joint Commission (TJC), The Centers for Medicare and Medicaid Services (CMS), federal and state regulations.

+ Performs onsite and/or remote focused assessments of regulatory and accreditation compliance including applicable federal, state, and local regulations and standards, emergency services, nursing services, and other clinical areas of organizational and/or patient safety and risk at HCA Healthcare facilities.

+ Conducts reviews of hospital/center systems to ensure compliance with applicable legal, regulatory and licensure requirements as defined by TJC, CMS, federal and state regulations and company policy for areas such as emergency services, nursing services, and other clinical areas of organizational and/or patient safety and risk.

+ Understands HCA Healthcare’s business and the healthcare industry from a global perspective by recognizing business trends and emerging technical and industry developments of relevance and communicates these to the client engagement team and applicable management personnel.

+ Discusses complex auditing issues with engagement team and client management.

+ Communicates the objectives of each review and planned other services to the client engagement team and establishes/communicates team members’ roles in the process.

+ Executes audit procedures, analyzes evidence, reaches conclusions, identifies issues, develops strategies, and makes decisions for complex, judgmental issues related to the review procedures executed. Consults with others in the Company, as necessary, on complex issues.

+ Reviews working papers and memoranda for consistency with applicable authoritative guidance and the requirements of the department.

+ Develops detailed reports specifying compliance issues identified during the audit.

+ Assists the facility with action plan development, follow-up questions. Completes process follow-up as necessary.

+ Provides input and guidance in the development of, as well as the review of the detailed audit/review programs particularly focusing on complex audit issues.

+ Participates in the audit quality assurance program.

+ Assists with educational and administrative matters (e.g. professional development programs, process improvement team initiatives, recruiting efforts, and special projects as requested by the Director).

SPECIFIC TESTWORK PERFORMED

+ TJC Hospital Accreditation Program (HAP), healthcare licensure regulations and CMS Conditions of Participation (CoP)/Conditions for Coverage.

+ Core measures and Healthcare Associated Infections such as Sepsis, Stroke, Central Line Associated Blood Stream Infections, Catheter Associated Urinary Tract Infections and others.

+ Procedures such as Carotid Stents, Implantable Cardiac Defibrillators, Pacemakers, Left Atrial Appendage Closure, TAVR, Bariatric surgery and other National Coverage Determinations.

+ Provider Licensure and Certification

+ Telehealth (Neuro Stroke)

+ United Kingdom Quality Measures

+ Inpatient Rehabilitation, Inpatient Psychiatric Services and others.

PROFESSIONAL/TECHNICAL SKILLS

+ Excellent communication skills in writing, speaking, and presenting.

+ Superior client service and business development skills, dedication to teamwork.

+ Ability to multitask and work well with deadlines/related time pressures

+ Proficient with Excel spreadsheet and Word processing software.

EDUCATION/EXPERIENCE/QUALIFICATIONS

+ Active RN Licensure with 5 or more years’ experience required.

+ BSN (from accredited School of Nursing) required.

+ Master’s degree preferred.

+ Experience, and/or certification supporting regulatory/accreditation/safety compliance required.

+ Nursing management/supervisory experience preferred.

+ Ability to travel up to 25-30%.

HCA Healthcare (Corporate), based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities, every person has a solid foundation for success. Nashville is also home to our Executive Development Program, where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Good people beget good people."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Sr Manager Clinical Compliance Reg Accreditation opening. Qualified candidates will be contacted for interviews. **Submit your resume today to join our community of caring!**

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.