IDT Regulatory Advisor

Job DescriptionJob Description

IDT Regulatory Advisor

The IDT Regulatory Advisor provides guidance in all aspects of IDT compliance and audits Service Delivery, Appeals and Grievance (SDAG) processes in all locations, to enhance the quality of care and ensure compliance with regulation. The IDT Regulatory Advisor is responsible for the integrity of the Service Delivery, Grievance and Appeals Universes at each PACE location. The IDT Regulatory Advisor, in collaboration with the Center Managers, also identifies clinical staff education needs in regard to documentation compliance and provides this education “just in time”. The IDT Regulatory Advisor is responsible for providing regulatory guidance to the members of the IDT and reports to the Quality and Compliance Director. The IDT Regulatory Advisor educates on standard SDAG processes and ensures these processes are implemented through collaboration with Center Managers.

SPECIFIC DUTIES AND FUNCTIONS:

• The IDT Regulatory Advisor monitors PACE sites and attends IDT and care plan updates daily to ensure regulatory compliance.
• Ensures Service Delivery, Grievance and Appeals documentation satisfies Federal and State regulatory requirements for PACE.
• Audits compliance controls, compliance procedures and operational processes and reports findings to the Director of Quality & Compliance.
• Guides IDT and all departments on SDAG compliance and proper use of electronic medical record to achieve compliance.
• Monitors and evaluates team use of the medical record to ensure all data is entered and complete.
• Reports SDAG Quality and Compliance monthly to the Quality Director.
• Coaches Center Managers on Grievances and Appeals documentation.
• Audits documentation in medical record tool for Grievances and Appeals data.
• Audits and reports Care Plan compliance to the Quality & Compliance Director.
• Provides monthly reports to the Quality & Compliance Director on Service Delivery, Appeals, Grievances, Care Plan updates and Care Plan compliance.
• Assists in preparation for internal/external site audits and regulatory activities.
• Completes special projects and other duties as assigned.
• Provides mandatory documentation/regulatory training as assigned.

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:

• Bachelor’s Degree with a minimum of two years’ experience in a management position in a health care setting.
• Compliance/Regulatory experience .
• Excellent verbal, written and interpersonal skills. Group presentation skills required.
• Ability to work with diverse populations/groups/teams. Demonstrate respect, sensitivity and flexibility.
• Strong analytical skills and attention to detail.
• Good working knowledge of computer software for word processing, format development and spreadsheet management is an absolute requirement.
• Good working knowledge and experience in electronic medical records and data retrieval from electronic medical records required.
• Must travel between sites to educate all staff.