Requisition #:194725
Location:Houston, TX 77098
Category:Compliance
Salary:$90,000 per year Position Details

Position Overview
The Regulatory Compliance and Coverage Specialist will report to the Director of Regulatory Compliance and Quality Review. The Regulatory Compliance and Coverage Specialist will complete detailed compliance reviews of all Aveanna locations. This role must be knowledgeable of Aveanna policies and procedures as well as Federal, State and Local regulations governing healthcare. The Regulatory Compliance and Coverage Specialist will monitor, analyze, and assess risk in all lines of business using standardized tools and available reporting metrics. This role will facilitate collaboration between the compliance department and all other clinical and operational departments within Aveanna Healthcare.

***This is a remote position.***

Requirements

Essential Job Functions

Performs onsite audits reviews in all lines of business within the Aveanna family of companies to identify risk and best practices involved in maintaining overall complianceUtilizes standardized evaluation methods and tools approved the Aveanna Compliance Department to ensure quality and establish trust and integrity in the Aveanna Internal Review process.Delivers timely reporting of internal reviews.  Monitors for quality and consistency of findings between internal reviewers across all regionsProvides education and feedback to locations related to OASIS and ICD Coding requirementsProvides guidance, training, and ongoing support to all Aveanna locationsCollaborates with other members of Aveanna Compliance Department to maintain reliability of the Aveanna Internal ReviewPursues knowledge of current rules and regulations that impact all lines of businessProvides support and coaching during the corrective action plan process to validate progress to goalsMaintains a collaborative relationship with other Aveanna leaders to become knowledgeable of new initiatives and programsProvides education to Aveanna leadership regarding Aveanna Compliance initiatives and processes Provides risk assessments and education to leaders related to Federal, State, and local regulationsContributes to the Aveanna Compliance Department by presenting accurate and timely reporting of risks and making recommendations for improvements to policies and procedures to enhance compliance

Requirements

Bachelor’s degree in Nursing or Therapy (or equivalent plus a minimum of 2 years clinical experience)Current license as an RNThorough knowledge of the home care industry, Medicare and Medicaid coverage requirements, clinical and operations practices, and a broad understanding of the Federal, State, and local regulatory requirements.Must be knowledgeable in OASIS and diagnosis coding, certification preferred

Preferences

Minimum of 2 years managerial experienceMinimum of 2 years experience in healthcare compliance related activities (clinical record review, qualityassurance, performance improvement, auditing, or utilization review)

Headhunters and recruitment agencies may not submit resumes/CVs through this website or directly to managers. Aveanna does not accept unsolicited headhunter and agency resumes, and will not pay fees to any third-party agency or company that does not have a signed agreement with Aveanna.

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

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