What are the responsibilities and job description for the PRTF Compliance Inspector position at AFMC?
SCOPE OF POSITION:
Responsible for assigned inspections for Psychiatric Residential Treatment Facilities (PRTFs), review and reporting activities related to the Inspections of Care (IOC) contract. Collaborate with medical and other professional staff to accomplish goals within designated timeframes. Answers directly to the outreach supervisor and is accountable for ensuring services are implemented according to strategic directives and contract deliverables. Support the organization’s mission, vision, and values by exhibiting the following behaviors: Honesty, Excellence Accountability, Respect and Teamwork.
ESSENTIAL JOB FUNCTIONS:
- Must be able to travel within the state as needed to accomplish required site visits. Travel will be extensive at times, requiring overnight stays (up to 3-4 nights per week). Entering facilities at various times outside regular work hours (evenings or early mornings) to ensure compliance with specific provider regulations.
- Complete CMS required trainings related to PRTF surveys
- Conduct annual onsite PRTF surveys to ensure compliance with State and Federal regulations.
- Conduct onsite PRTF complaint investigations as required.
- Collaborate with team members to develop strategies to implement and achieve Inspections of Care PRTF objectives throughout the state of Arkansas.
- Understand and apply appropriate workflows in the performance of IOC activities.
- Participate in the planning, development, implementation, delivery, and evaluation of multiple program activities with respect to each review episode.
- Seek direction from direct supervisor for any survey related questions or issues during the inspection process.
- Write effective and accurate inspection summaries and submit them within appropriate time frame.
- Communicate data, AFMC project goals, performance indicators, and designated timelines to appropriate target audiences.
- Understand and utilize project-tracking database to document, collect, and interpret data to meet contractual and other reporting requirements. Maintain accurate statistical data.
- Maintain log of all IOC visits, including date, time, location, name, topics covered, feedback received, and recommendations made from the visit. The log should be entered into the project tracking system or other electronic file storage during the visit and after the onsite portion concludes. Additional documentation required after the onsite portion with the final report completed with contract requirements for the specific provider types.
- Identify, present, and discuss progress and issues relating to focus areas and suggest solutions to assist in program development.
- Ensure all activities address designated performance goals, the appropriate target audience, and are performed within designated time frame.
- Maintain knowledge of specific projects including but not limited to contract, contract deliverables, policies, and procedures, etc.
- Communicate effectively with internal and external clients. Represent AFMC at various external functions.
- Adhere to format, content, and style guidelines, considering usability and ensuring accuracy, consistency, and quality.
- Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance
- Additional other duties as assigned.
KNOWLEDGE, SKILLS, AND ABILITIES:
- Chart reviewing skills for behavioral health.
- Knowledge of medical necessity criteria.
- Knowledge restraint/seclusion documentation and incident review.
- Knowledge of Medicaid rules and regulations.
- Data analysis and sampling.
- Intermediate level computer skills (Excel, Word, Power Point and Outlook).
- Type 50 wpm.
- Exceptional skills in business English and spelling are required.
- Ability to maintain confidentiality.
- Strong oral and written communication skills.
- Ability to compile reports for clinical and regulatory audiences.
- Creativity.
- Customer service.
- Ability to meet deadlines.
- Attention to detail.
- Flexibility.
- Knowledge of HIT/EHR.
- Medical terminology.
- Ability to work collaboratively and independently to achieve stated goals.
- Initiative.
- Facilitator.
- Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients, and the public.
- Ability to multitask.
- Ability to prioritize.
- Strong organizational skills.
- Problem solving skills.
- Professionalism.
- Project management skills.
- Ability to read, interpret and apply laws, rules, and regulations.
- Knowledge of quality improvement processes and techniques.
- Valid driver’s license and active Auto insurance required.
- Travel including overnight required. Time management skills.
Physical and Sensory Requirements (With or Without the Aid of Mechanical Devices):
Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to travel as needed. Must be able to lift and transport 25 pounds. Must be capable of performing the essential job functions of this job, with or without reasonable accommodations.
EDUCATION:
Required: Bachelor’s degree in any of the following: Social Science field, Health Administration, Health Information Management, Behavioral Health, or related field.
Desirable: Certified Professional in Healthcare Quality (CPHQ), Certified in Healthcare Compliance, RHIA/RHIT, or similar credentials relevant to compliance/auditing.
EXPERIENCE:
Required: Three (3) years in a behavioral health or social service-related setting.
Desirable: Three (3) years in a clinical health care setting or related experience with AR Medicaid programs.
3 years in healthcare compliance, quality, utilization review, health information management, or behavioral health operations; PRTF/under 21 inpatient psych experience strongly preferred. Familiarity with PRTF State and Federal licensure requirements.
INTERNET REQUIREMENTS:
Reliable, high-speed wireless internet service (Wi-Fi)