Clinical Qual/Compli Admin Sr
Elevance Health

The Clinical Qual/Compli Admin Sr is responsible for participating in Quality Management (QM) activities that ensure programs meet accreditation and regulatory standards. Primary duties may include, but are not limited to:

• Prepares QM Department for oversight audits.
• Prepares corrective action plans in response to oversight body's request.
• Conducts audits of QM processes and files.
• Writes policies and procedures.
• Assists with development of provider manuals, audit tools, and guidelines.
• Coordinates flow of information and documentation between associates responsible for day-to-day activities related to accreditation or regulatory reviews.
• Develops and implements accreditation and regulatory review tracking system.
• Maintains accreditation and/or regulatory review compliance library.
• Creates audit tools, reports, standardized policies and procedures, and provider manuals.
• Facilitates implementation of survey or regulatory recommendations.
• Assesses and evaluates progress towards meeting standards.
• Recommends new process.
• Trains associates on new and revised standards.
• Compiles documentation for presentation to accrediting/regulatory organization.

Requirements:

• AS in Nursing and minimum of 5 years of experience in a healthcare setting which includes a minimum of 3 years of quality management experience and/or experience preparing for regulatory/accreditation audits; or any combination of education and experience, which would provide an equivalent background.
• Current unrestricted RN license in applicable state(s) required.
• Knowledge of regulatory/accreditation standards strongly preferred.
• BSN preferred.
• Travels to worksite and other locations as necessary.

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