Regulatory Relations Specialist jobs in Spartanburg, SC

Position Summary

The Regulatory Coordinator guides and supports over 100 MGC practices through Regulatory and Compliance processes and performance improvement activities.  Supports effective decision making related to clinical, operational, and service activities.  Facilitates regulatory preparation through standing committees, ongoing education, auditing processes, and mentoring of internal leadership.  To complete duties of this position, extensive travel to physician practice locations is required.

Minimum Requirements

Education

• High school graduate or equivalent

Experience        

• Three years clinical experience

License/Registration/Certifications       

• Certification as Medical Assistant (AAMA) or Registered Medical Assistant (AMT)

Preferred Requirements

Preferred Education      

• Associate Degree or higher

Preferred Experience   

• Three to five years clinical experience

Preferred License/Registration/Certifications   

• N/A

Core Job Responsibilities

• Serve as an internal resource for compliance of all state and federal regulatory standards, excluding financial compliance.
• Serve as liaison between internal leadership and the following regulatory agencies:

•  SC DHEC
• Department of Health and Human Services (DHHS)
• Office of Inspector General (OIG)
• Centers for Medicare and Medicaid (CMS)
• Det Norske Veritas (DNV)
• South Carolina LLR
• FBI
• The Compliance Team
• Improve Regulatory Compliance throughout the MGC organization by ensuring practices are following regulatory/certification standards: 
  • Using regulatory audit tool, perform auditing processes in all MGC practice locations to ensure compliance with requirements of regulatory/certifying agencies and report findings to Compliance Manager, Practice Manager, and Director and implement corrective action(s) as appropriate.
  • Perform chart audits to ensure inclusion of required elements:  identification, social data, evidence of consent forms, pertinent medical history, assessment of the health care status and health care needs of the patients, summary of the episode, disposition, and instructions to the patient, reports of physical examinations, diagnostic and laboratory test results, consultative findings, and Provider signature.
  • Monitor quality improvement, compliance, and regulatory initiatives data and report findings to leadership and implement corrective action(s) as appropriate.
  • Per certification requirements, prepare and present quality and performance improvement data during required Quality/Performance Improvement practice meetings.
  • Prepare and present findings of regulatory audits during required Staff and Provider meetings and implement corrective action(s) as appropriate.
  • Prepare and provide instruction and competency assessment on high level disinfection processes in the practices and implement corrective action(s) as appropriate.
  • To ensure compliance with SCDHEC Title B Regulations, perform Imaging audits and communicate findings to Compliance Manager, Practice Manager, Director, and Imaging Services Quality Specialist and implement corrective action(s) as appropriate.
    • In addition to auditing processes, maintains radiographic equipment and staffing logs.
  • Ensure CLIA documentation is maintained in all practices and communicates with SCDHEC to correct areas of deficiency.
  • Serve as a resource for clinical quality and process improvement strategy development.
• Work collaboratively with Enterprise Intelligence to prepare quarterly and annual data for Provider Quality Engagement Incentive (QEI) contract measures and AOP/LEM reporting.
• Establish and maintain good networking relationships with Physician Practices, Human Resources, Enterprise Intelligence, IT, Imaging Services, Facilities, Laboratory Services, Corporate Integrity, Environmental Services.
• Assist practices in preparation for Rural Health Clinic site surveys through on-going site assessments
• Must be able to respond calmly and efficiently in crisis situations.
• This job description documents only the most essential duties and responsibilities of the job and does not relieve the employee from performing other job-related duties as assigned.