Clinical Qual/Compli Admin Sr at Elevance Health

Posted in Other 10 days ago.

Location: Richmond, Virginia





Job Description:

The Clinical Qual/Compli Admin Sr is responsible for participating in Quality Management (QM) activities that ensure programs meet accreditation and regulatory standards. Primary duties may include, but are not limited to:


  • Prepares QM Department for oversight audits.

  • Prepares corrective action plans in response to oversight body's request.

  • Conducts audits of QM processes and files.

  • Writes policies and procedures.

  • Assists with development of provider manuals, audit tools, and guidelines.

  • Coordinates flow of information and documentation between associates responsible for day-to-day activities related to accreditation or regulatory reviews.

  • Develops and implements accreditation and regulatory review tracking system.

  • Maintains accreditation and/or regulatory review compliance library.

  • Creates audit tools, reports, standardized policies and procedures, and provider manuals.

  • Facilitates implementation of survey or regulatory recommendations.

  • Assesses and evaluates progress towards meeting standards.

  • Recommends new process.

  • Trains associates on new and revised standards.

  • Compiles documentation for presentation to accrediting/regulatory organization.



Requirements:


  • AS in Nursing and minimum of 5 years of experience in a healthcare setting which includes a minimum of 3 years of quality management experience and/or experience preparing for regulatory/accreditation audits; or any combination of education and experience, which would provide an equivalent background.

  • Current unrestricted RN license in applicable state(s) required.

  • Knowledge of regulatory/accreditation standards strongly preferred.

  • BSN preferred.

  • Travels to worksite and other locations as necessary.


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