Clinical Compliance Manager

Experience & Requirements

• Analyzes existing processes with focus on identifying gaps, non-value-added steps, and other impediments to efficient operations. Promotes and influences continuous quality improvement by providing insight and analysis on trends and issues in patient safety and clinical core processes.
• Ensure proper utilization of Riskonnect database; run reports as necessary for tracking and trending analysis; follow up with facilities and regions as necessary for questions; create and distribute reports; provide assistance with sites during pilot test and deployment of web-based quality improvement platform.
• Manages YesCare’s Compliance Program and advances its best interests as each pertains to the applicable states’ Department of Corrections Health Care Services regulatory monitoring entity.
• Establishes and maintains positive relationships with client partners, the monitoring entity, and legal counsel.
• Supports all critical clinical initiatives as required by the executive leadership including developing and implementing start up plans for new contracts.
• Participates in the RFP process, ensuring that all quality and clinical compliance metrics are identified, and strategies are created to ensure compliance with designated requirements.
• Creates and distributes reports (including dashboards) to client partners, YesCare Leadership, and other key external and internal stakeholders, as necessary.
• Analyzes operations and conducts routine compliance reviews, audits, and risk assessments for site, regional, and corporate leadership.
• Facilitates and participates in key training and education initiatives for mission critical YesCare staff.
• Manages all aspects of incident response with respect to compliance events.
• Develops plans and initiatives to address local, state, and/or federal consent decrees and litigation settlements.
• Partners with site/regional leadership to maintain and prepare site for accreditation with pertinent accreditation bodies (NCCHC/ACA, etc.).
• Collaborates and implements process improvement plans/projects with assistance from Quality Improvement and Patient Safety Managers; includes monitoring, recommending, tracking, and trending of process improvement projects.
• Tracks, monitors, and trends companywide complaints, compliments, and grievances.
• Responsible for writing and/or updating policies and procedures.
• Attend external and internal meetings as required.
• Provides clinical start-up support as part of the Patient Care Services team and may support training and education of staff, shadowing and supporting clinical process across the care continuum of services such as Intake, Sick Call, Chronic Care, etc.
• Supports the Safety Manager as necessary such as helping facilitate root cause analysis and other quality improvement efforts.
• Performs other duties as assigned.

A background check, security clearance and drug screening are required for this role.

YesCare is an Equal Opportunity/Affirmative Action Employer. In compliance with federal and state employment opportunity laws, qualified applicants are considered for all positions without regard to race, gender, national origin, religion, age, sexual orientation, disability, Vietnam era veteran, or disabled Veteran status. EOE including Disability/Protected Veterans.

Responsibilities

Below is a list of your responsibilities as a Clinical Compliance Manager with YesCare:

• Nursing degree required
• Current, unrestricted, nursing license required; compact nursing license preferred.
• Must maintain a current Healthcare CPR certification.
• Firm understanding of (and ability to apply) the essential elements of an effective compliance program (policies/procedures, communication strategy, training/education, etc.), and an immediate ability to demonstrate such.
• Proven ability to assess and troubleshoot processes and systems.
• Direct experience in analyzing operations, performing compliance reviews, evaluating, and recommending controls, and ensuring appropriate safeguards are in place.
• Minimum 3 years’ clinical experience required.
• Certified Correctional Healthcare Professional (CCHP) or must achieve within 2 years of employment.
• Healthcare analytics required, understanding of intermediate statistics preferred.
• Lean Six Sigma Green Belt required; Black Belt preferred.
• Strong presentation and facilitation skills, including the ability to conduct effective meetings with internal and external stakeholders.
• Ability to effectively interpret, utilize, and report data findings in a clear and efficient manner.
• Excellent communication and listening skills.
• Able to absorb and interpret information contained in proposals, contracts, standards, policy, and other literature as needed to ensure information is synthesized and understood.
• General knowledge of and experience with litigation and related court proceedings.
• Knowledge of healthcare delivery methods and/or managed care.
• Demonstrated proficiency with Microsoft Office tools such as Word, Excel, PowerPoint, Visio, SharePoint, and Access.
• Proficient with cloud based and/or electronic document libraries using web-based user tools.
• Ability to travel as business demands (up to 75%).
• Empathetic understanding of incarcerated people in a correctional facility; emotional stability, patience, tact and demonstrate emotional intelligence; alertness’ and keenness of observation.
• Ability to maintain appropriate relationships and clinically therapeutic boundaries with incarcerated individuals, custody staff, clients, and vendors.
• Subject to initial and ongoing security clearance required.
• Must follow YesCare and departmental policies and procedures at all times.

YesCare Benefits (only applicable for full-time positions)

• Health, Dental and Vision Insurance
• Life and Disability Insurance
• Generous PTO plan
• 401k with matching funds
• Employee Discount and Rewards Program
• Tuition Assistance
• Continuing Education Reimbursement

About YesCare Health

By choosing a career with YesCare, you are choosing the opportunity to truly make a difference in the health, well-being, and future of the patients you serve. We take pride in being a pioneer provider of correctional healthcare. As a YesCare professional, you have access to the resources and support to enhance your skills, build a solid foundation to reach your career potential, and contribute to the care and well-being of an underserved population. There is no greater calling. Join YesCare today and be part of our legacy of innovation and clinical expertise.