PRTF Compliance Inspector, RN

AFMC; Little Rock (AR); On-site; USD 60,000 - 80,000; Full time

Job summary

AFMC seeks a PRTF Compliance Inspector, RN, to perform onsite inspections of Psychiatric Residential Treatment Facilities throughout Arkansas. You will assess adherence to federal and state regulations under the IOC contract and work with medical and other staff to meet tight timelines.

Travel is extensive, with overnight stays up to 3-4 nights weekly. The role requires an Associate Degree and strong knowledge of Medicaid rules, medical necessity criteria, and data analysis.

Qualifications

• Knowledge of behavioral health chart reviews.
• Understanding medical necessity criteria.
• Understanding restraint/seclusion documentation and incident review.
• Knowledge of Medicaid rules and regulations.
• Experience with data analysis and sampling.
• Proficient with Excel, Word, PowerPoint and Outlook.
• Typing speed of 50 wpm.

Responsibilities

• Travel within Arkansas for site visits, up to 3–4 nights per week.
• Enter facility visits and coordinate with providers outside regular hours.
• Complete CMS trainings related to PRTF surveys.
• Conduct annual onsite PRTF surveys for regulatory compliance.
• Investigate onsite PRTF complaints as required.
• Collaborate with team to implement IOC PRTF objectives statewide.
• Provide guidance to non-clinical staff on reviewer questions.
• Prepare concise review summaries and report timely.
• Maintain files and logs per procedures and contract requirements.
• Maintain project-tracking data and key statistics.
• Document visits with location, date, topics, feedback, and actions.

Skills

Chart review

Medical necessity criteria

Restraint/seclusion documentation

Medicaid rules

Data analysis

Microsoft Office

Typing speed 50 wpm

Education

Associate Degree

Job description

PRTF Compliance Inspector, RN - (26-084)

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Job Title

PRTF Compliance Inspector, RN

Job Type

Full-Time

Category

Location

Traveler LR Based - Little Rock, AR 72201 US (Primary)

Education

Associate Degree

Travel

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.

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