Job Description

GENERAL PURPOSE:

Primary function is to provide healthcare and related services to the patient in their place of residence; assist in providing a safe and clean environment, work cooperatively with patient and family and share observations and problems with the supervisor. Works under the direction and supervision of a registered nurse.

ESSENTIAL FUNCTIONS:

• Reporting to the agency's governing body, and CEO on the progress of developing, implementing, and establishing methods designed to improve the agency's efficiency and quality of services, ensure compliance and to reduce the agency's vulnerability to fraud, abuse, and waste.

• Monitoring the day-to-day compliance activities engaged in by the agency as well as any reporting obligations.

• Developing and implementing and revising policies, procedures, and practices designed to ensure compliance.

• Reviewing employees' certifications that they have received, read, and understood, and abide by the standards of conduct.

• Developing, coordinating, and participating in a multifaceted educational and training program that focuses on the elements of the compliance program.

• Ensuring the independent contractors and agents who furnish nursing or other health care services to the clients of the agency, or billing services to the agency, are aware of the requirements of the agency's compliance program with respect to coverage, billing, and marketing.

• Coordinating personnel issues to ensure that the National Practitioner Data Bank and Cumulative Sanction Report have been checked with respect to all Covered Persons.

• Assisting the agency's financial management in coordinating internal compliance review and monitoring activities, including annual or periodic reviews of departments.

• Independently investigating and acting on matters related to compliance, including the flexibility to design and coordinate internal investigations and any resulting corrective action with all departments, subcontracted providers, and health care professionals under the agency's control.

• Developing policies and programs that encourage managers and employees to report suspected fraud and other improprieties without fear of retaliation.

• Continuing the momentum of the compliance program and the accomplishment of its objectives long after the initial years of implementation.

QUALIFICATIONS:

Education:

• High School Diploma preferred.

• Has successfully completed one of the following:

A) Training program/competency eval as specified in §418.76 (b) (c) of the Medicare regulations.

B) Competency eval program that meets §418.76 (c)

C) Nurse Aide training/competency eval program approved by the state and listed in good standing on the state nurse aide registry:

D) State Licensure program that meets requirements of §418.76

Skills:

• Must be able to read and write in English and follow written and verbal instructions in English effectively.

• Demonstrates interest in the welfare of the ill and elderly.

• Must pass Aide Competency Evaluation Skills Checklist that meets §418.76(c) and written skills test.

PHYSICAL AND MENTAL EFFORT:

Prolonged sitting is required. Requires ability to always handle stressful situations in a calm and courteous manner. Requires working under some stressful conditions to meet deadlines and agency needs.

ENVIRONMENTAL AND WORKING CONDITIONS:

Works in an office environment, ability to work a flexible schedule; ability to travel locally; some exposure to unpleasant weather.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities. 

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