Don't worry, we can still help! Below, please find related information to help you with your job search.
- Manager Operational Performance and Oversight
- Oversight Officer
- Remote Patient Monitoring Rn
- Rn Day Shift Remote
- Chief Of Research Oversight And Compliance
- Rn Triage Specialist Remote
- Optimization Oversight Coordinator
- Remote Utilization Management Nurse Rn
- Construction Oversight
- Telephonic Case Manager Rn Remote
Delegation Oversight Rn (Remote)
Company | Baylor Scott & White Health |
Address | , Remote |
Employment type | |
Salary | $36.26 an hour |
Expires | 2023-06-07 |
Posted at | 1 year ago |
JOB SUMMARY
The Delegation Oversight Nurse is accountable for the delegation oversight activities of all Health Services Department (HSD) delegated vendors including Appeals & Grievances, Case Management and Utilization Management. This position ensures all delegated entities are following all federal, state, and local laws and accreditation requirements as well as contractual obligations. The Delegation Oversight Nurse is accountable for the completion of delegation oversight audits and logs, identification of gaps and initiation of corrective action plans in conjunction with the HSD Directors and Compliance.
SALARY
The pay range for this position is $36.26 (entry-level qualifications) - $56.19 (highly experienced) The specific rate will depend upon the successful candidate’s specific qualifications and prior experience.
ESSENTIAL FUNCTIONS OF THE ROLE
- Oversees and ensures compliance with state/federal regulatory and accreditation requirements. Researches regulatory and accreditation changes and the impact to business; provides regular updates to HSD Leadership and Compliance.
- Presents delegation oversight findings/activities in partnership with internal stakeholders.
- Completes monthly audits of all HSD department delegates and documents all findings on the delegation oversight logs.
- Works with Compliance to finalize CAPs, deliver them to the delegated entities and follow up on closure of the CAPs.
- Prepares a summary of audit findings and communicates significant findings to management in a timely manner following audit completion. Prepares and submits documentation of required follow-up reviews on previous audit findings. Conducts follow-up reviews to assess and verify effectiveness of any implemented action plans.
- Works collaboratively with department leadership to identify significant findings and prepare corrective action plans (CAPs).
- Works with Compliance on behalf of HSD departments in the completion of the annual delegation risk assessments as well as in the annual delegation auditing activity.
- Assists in the development of appropriate audit tools. Conducts and reports on audits as assigned to assist in management's documentation of compliance with regulatory, accreditation and operational process improvement standards.
KEY SUCCESS FACTORS
- Knowledge of internal quality controls in compliance with department policies and procedures.
- General computer skills, including but not limited to: Microsoft Office, information security, electronic medical documentation, and email.
- Must have critical thinking and problem-solving skills.
- Must have a working knowledge of key quality and regulatory organizations, such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Institute for Healthcare Improvement (IHI), the National Association for Healthcare Quality (NAHQ) and the National Committee on Quality Assurance (NCQA), Texas Department of Insurance (TDI), Health and Human Services Commission (HHSC), Centers for Medicare and Medicaid Services (CMS) and the Department of Labor.
- Experience with MCO (Managed Care Organization) operations relative to care management, utilization management or appeals and grievances.
- Social skills to interact with a wide range of constituencies.
- Ability to stabilize multiple demands and respond to time constraints.
- Must be able to communicate thoughts clearly, both verbally and in writing.
- Ability to pay attention to detail with emphasis on reporting skills.
BENEFITS
Our competitive benefits package includes the following
- PTO accrual beginning Day 1
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- Immediate eligibility for health and welfare benefits
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS- EDUCATION - Associate's
- MAJOR - Nursing
- EXPERIENCE - 3 Years of Experience
- CERTIFICATION/LICENSE/REGISTRATION -
Registered Nurse (RN)
-
Systems Analyst - Excel, Xml, Sql, Scripting
By CyberCoders At Salt Lake City, UT, United States 8 months ago
-
(Senior) Finance & Shared Services Manager
By Catholics For Choice At Washington, DC, United States 8 months ago
-
Paralegal - Probate Administration
By CyberCoders At Miami, FL, United States 8 months ago
-
Account Executive - Automotive Software
By ECW Search At United States 8 months ago
-
Construction Project Coordinator Jobs
By CyberCoders At River Falls, WI, United States 8 months ago