PRTF Compliance Inspector

Arkansas Foundation for Medical Care; Fort Smith (AR); On-site; USD 55,000 - 85,000; Full time

Job summary

AFMC is seeking a PRTF Compliance Inspector to lead inspections of Psychiatric Residential Treatment Facilities across Arkansas.

The role requires traveling within the state, conducting surveys, and reporting on regulatory compliance, with emphasis on HIPAA and data integrity. A Bachelor’s degree and healthcare compliance experience are essential; CPHQ/CHC/RHIA/RHIT are desirable credentials.

Qualifications

• Bachelor’s degree in a related field is required.
• Minimum of 3 years in a behavioral health or related setting.
• Experience in healthcare compliance, quality, or utilization review is preferred.
• Desirable: CPQH/CHC/RHIA/RHIT credentials relevant to compliance/auditing.

Responsibilities

• Travel within the state for site visits; overnight stays up to 3–4 nights per week.
• Complete CMS trainings related to PRTF surveys.
• Conduct annual onsite PRTF surveys for regulatory compliance.
• Conduct onsite PRTF complaint investigations as required.
• Collaborate to implement IOC objectives across Arkansas.
• Maintain project-tracking data and logs; prepare timely reports.

Skills

Chart review

Medical necessity

Medicaid rules

Data analysis

Excel

Typing speed

HIPAA compliance

Strong communication

Education

Bachelor's degree

Healthcare quality certifications

Job description

Job Title

PRTF Compliance Inspector

Job Type

Full-Time

Location

Traveler FSM Based - Fort Smith, AR 72903 US
Traveler LR Based - Little Rock, AR 72201 US (Primary)

Education

Bachelor's Degree

Job Description

SCOPE OF POSITION: Responsible for assigned inspections for Psychiatric Residential Treatment Facilities (PRTFs), review and reporting activities related to the Inspections of Care (IOC) contract. Collaborate with medical and other professional staff to accomplish goals within designated timeframes. Answers directly to the outreach supervisor and is accountable for ensuring services are implemented according to strategic directives and contract deliverables. Support the organization’s mission, vision, and values by exhibiting the following behaviors: Honesty, Excellence Accountability, Respect and Teamwork.

ESSENTIAL JOB FUNCTIONS

• Must be able to travel within the state as needed to accomplish required site visits. Travel will be extensive at times, requiring overnight stays (up to 3-4 nights per week). Entering facilities at various times outside regular work hours (evenings or early mornings) to ensure compliance with specific provider regulations.
• Complete CMS required trainings related to PRTF surveys
• Conduct annual onsite PRTF surveys to ensure compliance with State and Federal regulations.
• Conduct onsite PRTF complaint investigations as required.
• Collaborate with team members to develop strategies to implement and achieve Inspections of Care PRTF objectives throughout the state of Arkansas.
• Understand and apply appropriate workflows in the performance of IOC activities.
• Participate in the planning, development, implementation, delivery, and evaluation of multiple program activities with respect to each review episode.
• Seek direction from direct supervisor for any survey related questions or issues during the inspection process.
• Write effective and accurate inspection summaries and submit them within appropriate time frame.
• Communicate data, AFMC project goals, performance indicators, and designated timelines to appropriate target audiences.
• Understand and utilize project-tracking database to document, collect, and interpret data to meet contractual and other reporting requirements. Maintain accurate statistical data.
• Maintain log of all IOC visits, including date, time, location, name, topics covered, feedback received, and recommendations made from the visit. The log should be entered into the project tracking system or other electronic file storage during the visit and after the onsite portion concludes. Additional documentation required after the onsite portion with the final report completed with contract requirements for the specific provider types.
• Identify, present, and discuss progress and issues relating to focus areas and suggest solutions to assist in program development.
• Ensure all activities address designated performance goals, the appropriate target audience, and are performed within designated time frame.
• Maintain knowledge of specific projects including but not limited to contract, contract deliverables, policies, and procedures, etc.
• Communicate effectively with internal and external clients. Represent AFMC at various external functions.
• Adhere to format, content, and style guidelines, considering usability and ensuring accuracy, consistency, and quality.
• Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance
• Additional other duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES

• Chart reviewing skills for behavioral health.
• Knowledge of medical necessity criteria.
• Knowledge restraint/seclusion documentation and incident review.
• Knowledge of Medicaid rules and regulations.
• Data analysis and sampling.
• Intermediate level computer skills (Excel, Word, Power Point and Outlook).
• Type 50 wpm.
• Exceptional skills in business English and spelling are required.
• Ability to maintain confidentiality.
• Strong oral and written communication skills.
• Ability to compile reports for clinical and regulatory audiences.
• Creativity.
• Ability to meet deadlines.
• Flexibility.
• Knowledge of HIT/EHR.
• Medical terminology.
• Ability to work collaboratively and independently to achieve stated goals.
• Initiative.
• Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients, and the public.
• Ability to multitask.
• Ability to prioritize.
• Strong organizational skills.
• Professionalism.
• Ability to read, interpret and apply laws, rules, and regulations.
• Knowledge of quality improvement processes and techniques.
• Valid driver’s license and active Auto insurance required.
• Travel including overnight required.

Job Requirements

PHYSICAL AND SENSORY REQUIREMENTS (WITH OR WITHOUT THE AID OF MECHANICAL DEVICES)

Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to travel as needed. Must be able to lift and transport 25 pounds. Must be capable of performing the essential job functions of this job, with or without reasonable accommodations.

EDUCATION

Required : Bachelor’s degree in any of the following: Social Science field, Health Administration, Health Information Management, Behavioral Health, or related field.
Desirable : Certified Professional in Healthcare Quality (CPHQ), Certified in Healthcare Compliance, RHIA/RHIT, or similar credentials relevant to compliance/auditing.

EXPERIENCE

Required : Three (3) years in a behavioral health or social service-related setting.
Desirable : Three (3) years in a clinical health care setting or related experience with AR Medicaid programs.
3+ years in healthcare compliance, quality, utilization review, health information management, or behavioral health operations; PRTF/under 21 inpatient psych experience strongly preferred. Familiarity with PRTF State and Federal licensure requirements.

INTERNET REQUIREMENTS

Reliable, high-speed wireless internet service (Wi-Fi)

EQUAL OPPORTUNITY EMPLOYER/ VETERANS/ DISABLED EEO IS THE LAW

AFMC, Inc. is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability or any other status protected by federal, state and/or local law. AFMC invites any employee and/or applicant to review the Company’s Affiantive Action Plan. This plan is available for inspection upon request, which may be made in person or by telephone [phone], by fax [phone] or by U.S. mail Attn: Human Resources, 1020 West 4th Street, Suite 400, Little Rock, AR 72201.