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RN Sanction Specialist in Tampa, FL at KEPRO

Date Posted: 6/28/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Tampa, FL
  • Job Type:
    Nurse
  • Experience:
    Not Specified
  • Date Posted:
    6/28/2018

Job Description

KEYSTONE PEER REVIEW ORGANIZATION, INC.

JOB DESCRIPTION

Job Title: SANCTION SPECIALIST (Exempt)
Reports To: Review Operations Manager

Summary Description



Responsible for the oversight and direction of all activities 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;
  • Produce the written Office of Inspector General (OIG) referral if determined to be necessary;
  • Maintain case file, with all supporting documentation, for potential OIG referral;
  • Make recommendations for healthcare provider/practitioner’s Corrective Action Plan;
  • Monitor healthcare provider/practitioner’s Corrective Action plan and provide technical assistance to said providers as needed;
  • Maintaining all timelines associated with Sanction Activities;
  • Providing monthly summaries/updates for the CMS report;
  • Researching and reporting on medical and legal topics;
Qualifications Unrestrictive and active Nursing license as a Registered Nurse (RN); BSN is preferred; along with Certified Professional in Healthcare Risk Management (CPHRM); Licensed Healthcare Risk Manager (LHRM); or Associate in Risk Management (ARM).

  • Excellent verbal and written communication skills
  • Proficiency in planning, coordinating and implementing patient and staff safety procedures
  • Good judgment and decision-making abilities
  • Critical thinking and ability to prioritize tasks
  • Strong interpersonal, organizational and customer service skills
  • Ability to effectively meet contract timelines/deadlines
  • Ability to work independently and as part of a team
  • Ability to research/identify and apply appropriate standards of care
  • Talent for leading and facilitating group and team meetings
  • Attention to detail and analytical skills
  • Ability to maintain a calm, professional demeanor under pressure
  • Ability to manage change, growth, changing priorities 
  • Five years’ clinical experience in either a short-term acute care hospital or skilled nursing facility
  • Five years’ previous experience as a claims or risk manager preferred
  • Previous experience reviewing and investigating patient complaints
  • Previous experience in communicating with patients, family members, healthcare providers/practitioners, and government officials
  • Previous quality improvement experience
Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel.





 








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