MAJOR POSITION DUTIES AND RESPONSIBILITIES:

• In conjunction with the other regional monitoring team members, perform remote and on-site monitoring sessions for OLTL enrolled providers.
• Review providers’ written documentation to ensure that all fiscal requirements are being met.
• Interview provider staff, stakeholders, and consumers as part of the monitoring process.
• Assist in gathering necessary background data to determine what the providers strengths and weaknesses have been in the past including fraud and financial abuse, fiscal soundness, percent of billings.
• Assist in the preparation of and any changes to data collection tools.
• Organize monitoring data into a cohesive quality management report for each provider entity.
• Perform research through direct contact or by electronic means.
• Analyze a variety of material and data and develop conclusions.
• Successfully communicate findings.
• Research necessary information, applicable laws, regulations, and policies governing the provider entity.
• Assist in the preparation of monitoring objectives.
• Remain alert to indications of fraud, abuse, or deficiencies.
• Perform monitoring fieldwork.
• Participate in conferences and meetings with provider entities.
• Assess whether the provider entity has complied with applicable regulations and guidelines.
• Compile data obtained during monitoring visits with other members of the regional monitoring team, for compilation of reports.
• Assess whether the provider entity has maintained sound fiscal practices, billed DHS properly, and used DHS funds in accordance with program guidelines.
• Determine the appropriateness of costs claimed for DHS subsidy.
• Determine whether an entity is managing and utilizing its resources economically and effectively.
• Identify the causes of inefficient or uneconomical practices
• Travel across the State (includes overnight stays) as needed

About Us:

TulaRay partners with clients to create staffing solutions that meet unique organizational needs. Our services are designed to reduce administrative burdens, protect your brand, and improve assignment time-to-fill. We believe that mutually successful client relationships are built on lasting quality and exceptional customer service. We pride ourselves on our uncompromising commitment to high-quality emergency management & healthcare personnel, while ensuring that our clients are taken care of with personalized attention. TulaRay manages total compliance and respectfully supports hundreds of professionals and patient-centered programs.

TulaRay is proud to be an affirmative action employer and is committed to providing equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or special need that requires accommodation, please let us know by visiting our website at tularay.com