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RN Sanction Specialist in Tampa, FL at KEPRO

Date Posted: 1/29/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Tampa, FL
  • Job Type:
    Nurse
  • Experience:
    Not Specified
  • Date Posted:
    1/29/2018

Job Description

KEYSTONEPEER REVIEW ORGANIZATION, INC.

JOBDESCRIPTION

Job Title: SANCTION SPECIALIST (Exempt)


Reports To: Review Operations Manager

Summary Description





Responsible for the oversight and direction of allactivities associated with CMS’ Sanction process. 




Accountabilities


  • Produce the written Initial and Final Sanction Notices; to include:
    • Identified concern/s
    • Peer Reviewer determination
    • Standard of Care utilized
    • Statement as to how the healthcare provider/practitioner failed to meet his/her obligations as defined in §1156;
  • Producethe written Office of Inspector General (OIG) referral if determined to benecessary;
  • Maintaincase file, with all supporting documentation, for potential OIG referral;
  • Makerecommendations for healthcare provider/practitioner’s Corrective Action Plan;
  • Monitorhealthcare provider/practitioner’s Corrective Action plan and provide technicalassistance to said providers as needed;
  • Maintainingall timelines associated with Sanction Activities;
  • Providingmonthly summaries/updates for the CMS report;
  • Researching and reporting on medical and legal topics;


Qualifications

Unrestrictive and active Nursing license as a RegisteredNurse (RN); BSN is preferred; along with CertifiedProfessional in Healthcare Risk Management (CPHRM); Licensed Healthcare RiskManager (LHRM); or Associate in Risk Management (ARM).

  • Excellentverbal and written communication skills
  • Proficiencyin planning, coordinating and implementing patient and staff safety procedures
  • Goodjudgment and decision-making abilities
  • Criticalthinking and ability to prioritize tasks
  • Stronginterpersonal, organizational and customer service skills
  • Abilityto effectively meet contract timelines/deadlines
  • Abilityto work independently and as part of a team
  • Abilityto research/identify and apply appropriate standards of care
  • Talentfor leading and facilitating group and team meetings

  • Attentionto detail and analytical skills
  • Ability to maintain a calm, professionaldemeanor under pressure
  • Ability to manage change, growth, changing priorities 
  • Five years’ clinical experience in either ashort-term acute care hospital or skilled nursing facility
  • Five years’ previous experience as a claims orrisk manager preferred
  • Previous experience reviewing and investigatingpatient complaints
  • Previous experience in communicating withpatients, family members, healthcare providers/practitioners, and governmentofficials
  • Previous quality improvement experience
Reasonable accommodations will be made asrequired by law in an attempt to enable an individual with a disability toperform the essential functions of this job. While performing the duties ofthis job, the employee is regularly required to sit for prolonged periods oftime; key and/or control objects; occasionally lift and/or move objects weighing up to 10pounds; and occasionally travel.





 













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