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Compliance Leadership Position - Not for Profit Organization

University of Washington Physicians (UWP) in Seattle, Washington is an academic faculty practice group of more than 1,500 physicians and health-care providers who practice at several major medical centers in the greater Seattle area and community-based practice sites around the state of Washington. Our clinicians are among the best and most sought-after in the world providing care for over a million patient visits each year in our outpatient primary-care clinics, specialty clinics, and emergency departments.UW Physicians has a current vacancy in its Compliance Officer position. This leadership position is responsible for developing and overseeing implementation of the compliance program for UW Physicians. Reporting to the Executive Director of UWP, this position also has a reporting relationship to the Associate Vice President for Medical Affairs/Chief Compliance Officer (AVP/CCO) for UW Medicine.The Compliance Officer plays an essential role as the primary content expert for clinical billing and documentation. He/she advises the Board of Trustees, the Business Excellence Committee, the President, Executive Director, Department Chairs and Clinical Directors, and Faculty on compliance risk assessment and mitigation strategies and establishes the audit, monitoring, and education programs. The Compliance Officer works cooperatively with compliance officers within the UW Medicine System and Children´s University Medical Group (CUMG) to ensure system-wide consistency in compliance practices and to identify and resolve shared issues and concerns.Qualifications for the Compliance Officer include the following: Bachelor´s degree in Business Administration, health information, or related field required. Master´s degree preferred; Five years experience in health care compliance required; Five years management experience required; Two years experience in academic health care environment required; In-depth knowledge of federal and state regulations as they pertain to physicians and other health care providers; Knowledge of physician billing, coding (CPT and ICD-9), and documentation required. Coding certification preferred; Ability to communicate effectively, both verbally and in writing, with employees, medical staff, board members, and external parties. Strong presentation skills; Ability to deal effectively with difficult situations; Ability to analyze information and evaluate results to choose the best solution and solve problems; Knowledge of business and management principles involved in strategic planning, resource allocation, human resources management and leadership, production methods, and coordination of people and resources; Proficiency with Windows based software and Microsoft Office Suite products.UW PhysiciansEqual Opportunity Employer

Qualifications: Current California RN license. BSN or BA or BS degree in healthcare related field such as management, health services administration. At least three (3) to five (5) years experience in utilization management and discharge planning in an acute care setting to also include previous supervisory or management experience. Demonstrated knowledge of operations and healthcare management; JCAHO, Title XXII, Medicare, MediCal and other local, state and federal regulations. Knowledge of managed care operations. Demonstrated interpersonal, negotiation, and management skills. Good oral and written communication skills.Duties: Assists in developing and maintaining policies and procedures for the Service Area or Medical Center related to Utilization Management. Collaborates with the multi disciplinary team´s to plan and coordinate care across the continuum. Coordinates and manages members´ care with non KFH hospital facilities and providers. Identifies risk management and quality of care issues across the continuum. Surfaces issues and any suggestions to the appropriate multi disciplinary team members. Manages transportation program to ensure appropriate utilization of resources which meet Health Plan guidelines and patient needs. Assures compliance with Federal, State, JCAHO, NCQA, other regulatory agencies and internal standards and requirements.Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services across the continuum of care. Assists in conducting statistical studies in utilization trends, patterns, and outcomes. Hires, trains coaches, disciplines professional and clerical support staff. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente´s Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanente´s policies and procedures.In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the Kaiser Permanente Service Quality Credo, the KP Mission as well as specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our members, and to purchasers, contracted providers and vendors.Kaiser Permanente is an EEO/AA Employer.Notes: Schedule varies.

You´ll Find A Great Place to WorkVail Valley Medical Center

Department: Quality Resources Management Schedule: Full-time (Year Around) Shift: Days Hours: 8am-5pm Job Details: - RN - BSN Preferred This position is responsible to review and assess VVMCs operations to abstract and develop data to assess VVMCs compliance with accreditation and other regulatory standards as well as to identify priority areas for quality improvement. This position will also support the investigation and follow-up on root cause analyses and other performance improvement activities.

Part of Sunrise Health, MountainView Hospital is a full-service modern 250-bed facility in the heart of northwest Las Vegas. Here we offer a family-like culture and stress a team-based approach, aimed at continuing to achieve high levels of patient satisfaction. We are known for our low nurse-to-patient ratio and specialty adult and pediatric intensive care units, and were honored with a Service Excellence Award for womens health and maternity care. We currently have an opportunity for a full-time Quality Management Coordinator who will assume organizational responsibility for medical staff peer review functions and assigned quality improvement initiatives. The Coordinator will serve as team leader for selected quality improvement projects as assigned. In addition, the Coordinator will design and implement quality studies; perform medical record review for abstraction of data for core measures and/or clinical review for peer review and oversee ongoing professional practice evaluation (OPPE). Qualified candidates must have: Nevada Registered Nurse License Bachelors Degree in Nursing or health related field, Masters Degree preferred Professional in Healthcare Quality Certification preferred A minimum of three years recent experience in medical staff peer review/quality management preferred Experience with Microsoft Office, database management preferred Understanding of data management systems Intermediate computer knowledge and expertise At Sunrise Health were guided by a simple yet powerful motto, Another Sunrise. Another Miracle.. And while technology is at the forefront of everything we do, we havent forgotten that its our people who make miracles happen and help our patients heal. As part of our team, we provide you with a benefits package designed to meet your individual needs. Whether youre new to the area or a longtime resident, theres always something new to discover in Las Vegas. For more information please contact Pam at Pamela.Hulbert@hcahealthcare.com or visit our website at www.sunrisehealth.jobs/mountainview to learn more about our opportunities and all that Las Vegas has to offer.Sunrise Health is an equal opportunity employer.