Adverse Action Adjudicator Jobs

Classification: Contract

Contract Length: 6 months

Job ID: 16186114

Location: Nashville, TN

At CereCore, our heart for healthcare is interconnected with our knowledge of technical solutions, creating a vital link that ultimately drives the delivery of high-quality care. CereCore is seeking an Adverse Action Adjudicator to join our Nashville, TN team. This individual will work at one of the nation's leading providers of healthcare services, HCA Healthcare

Summary:

The Adverse Action Adjudicator is responsible for considering derogatory information presented in a background investigation report and renders a decision on the basis of that information. Must be neutral, without conflict of interest, to determine fairly if a discrepancy between disclosed credentials and verified information is sufficient to disqualify a candidate for employment.

Responsibilities:

• Create and maintain a record of adjudication decisions including justification for course of action
• Recommend process, product or service improvements.
• Evaluate the disclosed discrepancy in a balanced way before making a decision.
• Conduct investigations and recommend resolution in collaboration with Legal, Ethics and Compliance, Human Resources Business Partners and others as appropriate.
• Create and maintain decision analytics for reporting.
• Make a decision based on knowledge of law, regulation, policy, precedent, and judgment of risk to employer to proceed with approval or deny approval.
• Review background investigation results to confirm a discrepancy with credentials exists that is not addressed by the adjudication matrix.
• Solve unique and complex problems with a broad impact on the business.
• Schedule and regularly meet with operations management and Human Resources Business Partners.
• Monitor business challenges and/or regulatory issues that might influence adjudication.
• Operates without supervision in a complex environment.
• Keep all adjudication material confidential
• Periodically review for revision the adjudication matrix used by Recruiting.
• Interview background investigation vendor and/or the subject of the investigation if necessary to gain clarity.

Requirements:

• Computer and software literate
• Bachelor degree required
• At least 1 year experience in relevant work experience

CereCore was formed in 2001 as a shared service business within a large hospital operator. We focus solely on helping healthcare organizations align business and IT strategies to improve processes and patient care.

Awards and Recognition

• The U.S. Chamber of Commerce Foundation presented HCA Healthcare with the 7th Annual Hiring Our Heroes Lee Anderson Veteran and Military Spouse Employment Award.
• CereCore wins ClearlyRated's 2020 and 2021 "Best of Staffing" Client and Talent Awards for Service Excellence.
• Modern Healthcare selected CereCore as one of the 2020 "Best Places to Work in Healthcare."
• HCA Workplace Measures Up & Earns Computerworld 2017 "Best Places to Work in IT Award," an award we’ve earned since 2009.
• HCA has been named a World's Most Ethical Company® by the Ethisphere Institute for the ninth consecutive year.
• HCA has been named a Military Friendly® Employer for the eighth year in a row. We're proud to hire and support our nation's veterans – and proud of our employees.

Our Commitment to Diversity and Inclusion

We believe excellence in healthcare starts with a foundation of inclusion, compassion and respect for our patients and each other. We are committed to fostering a culture of inclusion across all areas of our organization. We are an equal opportunity employer and we value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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