PRTF Compliance Inspector, RN

Arkansas Foundation for Medical Care

Little Rock (AR)

On-site

USD 65,000 - 90,000

Full time

2 days ago

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Job summary

Arkansas Foundation for Medical Care seeks an Inspections of Care (IOC) specialist to perform onsite PRTF inspections and assessments for regulatory adherence. Travel across the state is required, with evening or overnight stays as needed.

The role emphasizes collaboration with medical staff, documentation of findings, and ensuring contract deliverables are met while maintaining HIPAA compliance.

Qualifications

Nursing diploma or associate degree required and AR RN license (unrestricted).
Desirable: Bachelor’s in nursing and related QA credentials.
Experience with behavioral health records and HIT/EHR helpful.
Knowledge of Medicaid rules and regulations.
Strong data collection and reporting capabilities.
Ability to read, interpret and apply laws and regulations.

Responsibilities

Perform onsite inspections of PRTFs and assess IOC compliance with state and federal regulations.
Travel within Arkansas; conduct site visits including evenings or early mornings as needed.
Document findings and prepare review summaries within required timeframes.
Maintain logs and project-tracking data per contract requirements.
Collaborate with team to implement IOC PRTF objectives across the state.
Follow confidentiality, HIPAA, and organizational data security protocols.

Skills

Chart reviewing

Medical necessity criteria

Data analysis

Intermediate computer skills

Written & verbal communication

Project management

Confidentiality & HIPAA

Time management

Multitasking

Relationship building

Problem solving

Education

Diploma or Associate degree in nursing

Registered Nurse licensure in Arkansas

Bachelor’s degree in nursing (desirable)

CPHQ / Healthcare quality credentials desirable

Tools

Excel

Word

PowerPoint

Outlook

Job description

SCOPE OF POSITION:

Responsible for inspections and assessments to determine Psychiatric Residential Treatment Facilities (PRTFs) adherence to federal and state regulations 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.

Description

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 IOC PRTF objectives throughout the state of Arkansas
Function as a resource for non-clinical staff by providing oversight and follow-up for clinically related questions or issues
Write effective and accurate review summaries and submit within appropriate time frame.
Maintain files for recording and reporting in accordance with established procedures.
Seek direction from Supervisor for any questions or issues during the review process.
Participate in the planning, development, implementation, delivery, and evaluation of multiple program activities with respect to each quality of care assessment.
Communicate effectively with internal and external clients.
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 onsite 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 at time of visit and when onsite visit concludes. Reports are to be 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 and are performed within designated time frame
Maintain knowledge of specific projects including contract, contract deliverables, policies, and procedures, etc.
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 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 presentations.
Creativity.
Customer service.
Ability to meet deadlines.
Attention to detail.
Flexibility.
Knowledge of HIT/EHR.
Medical terminology.
Ability to work collaboratively and independently to achieve stated goals.
Initiative.
Facilitator.
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.
Problem solving skills.
Professionalism.
Project management skills.
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.
Time management skills.

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

: Diploma or associate degree in nursing. Licensed as a Registered Nurse in the state of Arkansas, without restrictions.

Desirable

Desirable: Bachelor’s degree in nursing, health care, or related field. Certified Professional in Healthcare Quality (CPHQ), ), Certified in Healthcare Compliance, RHIA/RHIT, or similar credentials relevant to compliance/auditing.

Experience

Three (3) years of experience in behavioral health, social service, or juvenile justice.

Desirable: Experience in quality improvement or patient safety.

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)

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