Senior Clinical Compliance Manager, Nursing (Remote)

Coral Connect, LLC (“Coral”) is a technology-enabled service provider focused on reducing healthcare costs through intelligent data management, pharmacy optimization, and value-driven sourcing. Our mission is to make specialty care more accessible, efficient, and equitable by improving operations at community care organizations, infusion centers, and specialty providers.

Job Purpose

The Senior Clinical Compliance Manager will provide expert-level guidance to healthcare organizations to promote compliance with all relevant laws, regulations, accreditation standards, and industry best practices. In addition, the Senior Clinical Compliance Manager will advise on quality improvement (QI) and compliance strategies, conduct audits, provide education and training, and develop policies and procedures as part of the execution of client deliverables.

Responsibilities

• Lead and assist cross-functional and multidisciplinary projects, engaging and collaborating with stakeholders, ensuring the continuous delivery and support of accurate, compliant deliverables.

• Review, interpret, and apply all relevant rules, regulations, laws, accreditation standards, and best practice guidelines throughout internal and external work produced.

• Assist in developing, reviewing, implementing, and maintaining policies and procedures.

• Act on priority objectives to achieve desired results using knowledge of business drivers, operations, and capabilities to influence strategies to drive clinical and operational excellence and adherence to client contract requirements.

• Analyze, identify, and evaluate risk, employing knowledge and risk management tools and techniques to support client deliverables.

• Achieve operational objectives by contributing information and analysis to strategic plans.

• Identify and define quality metrics, coordinate data collection from various roles/functions, analyze outcomes, and prepare documentation and reports supporting client deliverables.

• Manage costs within the established budget parameters for all activities and projects.

• Create, plan, implement, and oversee clinical audit activities supporting accreditation readiness and quality compliance.

• Act as a technical expert resource for stakeholders and provide ongoing oversight of projects and deliverables to ensure adherence to established policies and procedures.

• Consult and advise clients on accreditation, compliance, and quality initiatives.

• Plan and implement training and education for internal and external stakeholders related to quality, accreditation, and regulatory requirements.

• Participate as a member of the accreditation assessment team, reviewing outputs to ensure that assessment principles and methodologies are correctly applied, documentation and calculations are accurate, and work is compliant with the accreditation standards, policies, and other applicable laws.

• Serve as a subject matter expert, applying knowledge and experience in the review of systems and products, providing the appropriate supporting documentation.

• Provide product development support, including creating education and training, validating quality processes, conducting quality control audits, monitoring performance, and providing clinical and operational improvement recommendations.

• Maintain a comprehensive understanding of quality standards, laws, regulations, and accreditation requirements.

• Update job knowledge by studying trends and developments in quality, regulatory, and accreditation requirements, participating in educational opportunities, reading professional publications, maintaining personal networks, participating in professional organizations, etc.

• Adhere to company time-tracking standards and all company policies and procedures.

• Perform other job duties as assigned.

Qualifications

• Minimum of five years’ experience with healthcare compliance, accreditation, and regulatory activities

• Demonstrated ability, at an intermediate level or higher, using a computer and available software to complete virtual activities, communicate with internal and external stakeholders, maintain records, and prepare technical reports

• Demonstrated proficiency with Microsoft Office Suite programs, with beginner to intermediate Excel skills

• Demonstrated ability to work independently and within a team environment

• Demonstrated ability to make accurate decisions based on objective and verifiable evidence

• Knowledge of relevant industry best practices, professional standards, laws, and regulations

• Excellent written and oral communication skills, with the ability to produce documents and presentations easily understood by the intended audience

• Excellent interpersonal skills with a proven ability to develop and maintain professional relationships with various internal and external stakeholders

• Excellent organizational skills and attention to detail

• Proven time management skills, ability to manage multiple simultaneous projects with competing priorities and deadlines

• Valid nursing license required; Bachelor of Science in Nursing (BSN) preferred 

License Requirements

• Professional licensure required by state

Job Benefits

• Health insurance

• Vision insurance

• Dental insurance

• Life insurance

• Retirement plan

• Paid time off

Location

• Remote with travel to client locations, internal business meetings, and other locations as needed.