Clinical Review Specialist Jobs

ACHC is currently recruiting a personable and detail-oriented Clinical Review Specialist to perform the associated duties which support and accomplish the accreditation process for the community based programs to include Home Health & Hospice programs.

This person will be responsible for providing interpretation of ACHC standards with special emphasis on standards issued related to specific settings, professional disciplines, or accreditation and certification programs. This person will also be educating surveyors and customers alike on the accreditation services and associated standards of ACHC, as well as participating in the development and revision of standards and survey processes.

The ideal candidate will possess a passion for quality and promoting improvement, along with the ability to think outside the box to do so. S/he should also exhibit exceptional communication skills with a positive demeanor that contributes to favorable and meaningful interactions with a variety of key stakeholders.

Responsibilities and Duties:

• Document all reviews per ACHC protocols.
• Conduct surveys, including complaint and focus surveys ensuring compliance with ACHC Standards for Accreditation if needed.
• Provide standards interpretation for customers and accreditation department staff for the community based programs which include Home Health, Hospice and Home Care
• Complete the Company Review Form and present the findings of the survey to the Accreditation Review Committee.
• Educate providers as needed to ensure POCs and Evidence comprehensively addresses deficiencies.
• Review Plans of Correction (POCs) submitted by providers for accuracy and completeness.
• Participate as an active member of the Accreditation Review Committee.
• Provide support to Program Leads for daily operational processes.
• Complete and submit post-accreditation Medicare paperwork.
• Review and recommend changes to department policies and work instructions to maintain the Quality Management System (QMS) and the integrity of departmental processes.
• Attends trade shows and workshops to promote all programs and services when needed. Prepares and conducts state and national presentations when needed.
• Review Evidence as submitted by providers for accuracy and completeness.
• Review Summary of Findings (SOF) documentation submitted by Surveyors, ensuring accuracy.

Qualifications and Skills:

• Proficient in Microsoft Office applications
• Must be willing to travel (15-20%)
• Must be fully vaccinated against COVID-19
• Customer service experience
• Five years of Home Health and Hospice experience that includes two years of quality assurance planning and implementation, management of a home health or hospice provider or experience that includes successfully becoming accredited.
• Strong oral and written communication skills and presentation skills.
• Experience working with computer systems with proficient use of database and other office system programs.
• Currently licensed Registered Nurse with a Home Health and Hospice background in quality or management, surveyor experience and knowledge of interpreting Medicare COPs and state licensure rules

This position is 100% remote and can be located anywhere nationwide.

In order to be considered, please send your resume along with your desired compensation.

At ACHC we aim to hire only the best. As a non-for-profit company with a rapidly growing base of influence within our markets, our philosophy is rooted in innovation, best-in-class customer service, integrity, and, quite simply, excellence. Our visionary market sensibility coupled with a workplace that has been recognized both locally and nationally as a Best Places to Work award recipient, ACHC provides a competitive salary along with a comprehensive benefits package featuring 100% paid Medical, Dental, and Vision benefits for individuals. If you regard yourself as goal-oriented and you would like to be part of a fun-loving, committed team of professionals who each play a vital role in providing our customers with the industry’s best customer service experience, we would love to have you join us.

Accreditation Commission for Health Care is an Equal Opportunity Employer.