Regulatory Licensing Specialist

ochsner; New Orleans (LA); On-site; USD 70,000 - 100,000; Full time

Job summary

Ochsner Health in New Orleans seeks an experienced Licensing & CMS Compliance Specialist to manage annual license renewals, enrollments, and CMS time studies. You will oversee multiple licensing projects, coordinate with stakeholders, and ensure adherence to state and federal standards across facilities.

The role requires a Bachelor's degree in healthcare or related field and at least 2 years in healthcare compliance. Travel regionally to multiple facilities is expected.

Qualifications

• Bachelor's degree in healthcare or related field is required.
• Minimum of 2 years in healthcare compliance, licensing and certification, operations, regulatory compliance, risk management, audit, law, or related field.
• Experience with healthcare licensing and certification or healthcare corporate compliance is preferred.
• Proficiency in Outlook, Microsoft Word, moderate-level Microsoft Excel, PowerPoint, Adobe, and other software/web-based applications.

Responsibilities

• Timely completion of annual hospital and facility license renewals for the system, tracking expiration dates and collecting onsite inspection reports to ensure new licenses are obtained.
• Manage several licensing projects concurrently and ensure they meet required standards and deadlines.
• Coordinate with project stakeholders to collect documents and information to complete licensing packets and communicate progress to stakeholders.
• Facilitate project management meetings and document notes and action items.
• Coordinate onsite environment surveys and prepare teams for survey readiness as licensing lead.
• Apply for initial Medicare and Medicaid enrollments for new hospitals, facilities, and provider types.
• Maintain and revalidate enrollments as required by CMS and utilize PECOS for enrollment submissions.
• Administer CMS Physician Time Study to collect data and train participants.

Skills

Analytical skills

Communication skills

Organizational skills

Attention to detail

Interpersonal skills

Travel willingness

Education

Bachelor's degree in healthcare or related field

Master's degree in healthcare or related field

Tools

Outlook

Microsoft Word

Excel

PowerPoint

Adobe

Job description

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

Job Summary

This job is responsible for licensing and certification processes and Centers for Medicare and Medicaid Services (CMS) time study administration for the organization. The role involves timely completion of annual license renewals for all facilities, managing the completion of several licensing projects concurrently to meet required standards and deadlines, and maintaining Medicare certifications/enrollments and Medicaid enrollments for all facilities. In addition, this position performs regulatory and compliance-related research. The role also involves the administration and reporting of CMS time studies according to federal regulations to support cost report activities. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Job Duties

• Timely completion of annual hospital and facility license renewals for the system, including tracking expiration dates and collecting onsite inspection reports to ensure new licenses are obtained, and ensures facility compliance with state-specific licensing standards and federal regulations, and remains knowledgeable on current federal and state regulations.
• Manages several licensing projects concurrently and ensures projects meet required standards assigned deadlines.
• Works with project stakeholders and external cohorts to collect required documents and information to complete licensing packets; communicates effectively and timely with key stakeholders about projects to resolve issues and meet deadlines.
• Facilitates project management meetings and ad hoc meetings, documents meeting notes, and completes related action items.
• Coordinates onsite on-site physical environment surveys, preparing clinical and operational teams to ensure survey readiness, and reporting onsite to act as licensing lead during those onsite surveys.
• Applies for initial Medicare and Medicaid enrollments for new hospitals, facilities, and provider types.
• Maintains existing Medicare and Medicaid enrollments, updates and revalidates enrollments as need or as required by CMS; utilizes PECOS (Provider Enrollment, Chain, and Ownership System) database to submit new enrollment applications and to update existing enrollments.
• Administers CMS Physician Time Study, which occurs 2 weeks per quarter, for a total of approximately 2,000 physicians. That includes updating the online database with participant information, maintaining instructions and training tools, conducting group and individual training sessions, monitoring and encouraging timely submission from all participants, performing quality audits of submitted time studies, and preparing quarterly and annual

Education

• Required - Bachelor's degree in healthcare or related field.
• Preferred - Master's degree in healthcare or related field.

Work Experience

• Required - 2 years in healthcare compliance, licensing and certification, operations, regulatory compliance, risk management, audit, law, or related field.
• Preferred - Experience with healthcare licensing and certification or healthcare corporate compliance issues.

Certifications

• Preferred - Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Certified in Healthcare Research Compliance (CHRC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS)

Knowledge Skills and Abilities (KSAs)

• Strong analytical and attention to detail skills.
• Highly effective verbal and written communication skills.
• Strong organizational and prioritization skills.
• Ability to gather information and understand problems to identify underlying issues.
• Strong interpersonal and team-building skills.
• Proficiency in Outlook, Microsoft Word, moderate-level Microsoft Excel, PowerPoint, Adobe, and other software/web-based applications.
• Ability to facilitate meetings and presentations to large groups.
• Ability to work under minimal supervision; Ability to travel regionally to various locations (Lafayette, Shreveport/Monroe, Baton Rouge, Houma, New Orleans, Chalmette, etc.).