JOB SUMMARY

The Nursing Corporate Compliance Consultant Registered Nurse (RN) is responsible for evaluating, analyzing, and providing informed opinions on healthcare delivery and its outcomes. This role involves collaborating with Corporate Compliance to identify process improvement opportunities, prevent claims, lawsuits, and government investigations, and promote education on healthcare facts and issues.

ESSENTIAL FUNCTIONS OF THE ROLE

Assess healthcare delivery and outcomes, collaborating with Legal, Revenue Cycle, and Operations Staff for process improvements. Educate on healthcare issues, aid in legal defense, and develop process enhancements. Present findings and oversee implementation. Organize medical and litigation records for internal and legal use.

Perform audits to ensure compliance with policies, procedures, and regulations.

Provide recommendations and detailed audit reports.

Monitor data and trends to identify and address deficiencies.

Act as a compliance resource for departments and entities within the institution.

Review and evaluate medical literature, regulations, and case law to assess standards of care.

Educate legal professionals on healthcare facts and issues in claims/lawsuits, providing informed opinions and strategizing.

Document incident reviews, resolutions, and corrective actions.

Update procedures and policies for compliance.

Coordinate investigations, report findings, and implement corrective actions.

Analyze medical and legal documents, provide detailed summaries to relevant parties, and interview healthcare personnel as needed.

KEY SUCCESS FACTORS

Strong nursing expertise adhering to legal standards, including patient care, and regulatory compliance.

Proficient in Microsoft Office (Word, Excel) with exceptional communication skills (written and verbal).

Skilled in analysis and judgment, committed to continuous professional growth and relevant certifications.

Knowledgeable in nursing laws, standards, and protocols, medical terminology, ethics, and patient privacy.

Proficient in critical thinking, problem-solving, and effective communication among medical staff.

Capable of providing patient-centered care, adapting plans as needed, and observing medical changes.

Competent in general computer usage and committed to obtaining Risk Management certification within one year.

BENEFITS

Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level

QUALIFICATIONS

- EDUCATION - Associate's

- EXPERIENCE - 5 Years of Experience

- CERTIFICATION/LICENSE/REGISTRATION -
Registered Nurse (RN)
- Hybrid expectation- roughly on-site 6x a year