Regulatory Licensing Specialist

Ochsner Healthcare Compliance Specialist

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

This job is responsible for licensing and certification processes and CMS time study administration for the organization. The role involves timely completion of annual license renewals for all facilities, managing the completion of several licensing projects concurrently to meet required standards and deadlines, and maintaining Medicare and Medicaid enrollments for all facilities. In addition, this position performs regulatory and compliance-related research. The role also involves the administration and reporting of CMS time studies according to federal regulations to support cost report activities.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Education

Required - Bachelor's degree in healthcare or related field.

Preferred Master's degree in healthcare or related field.

Work Experience

Required 2 years in healthcare compliance, licensing and certification, operations, regulatory compliance, risk management, audit, law, or related field.

Preferred - Experience with healthcare licensing and certification or healthcare corporate compliance issues.

Certifications

Preferred - Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC), Certified in Healthcare Research Compliance (CHRC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS)

Knowledge Skills and Abilities (KSAs)

• Strong analytical and attention to detail skills.
• Highly effective verbal and written communication skills.
• Strong organizational and prioritization skills.
• Ability to gather information and understand problems to identify underlying issues.
• Strong interpersonal and team-building skills.
• Proficiency in Outlook, Microsoft Word, moderate-level Microsoft Excel, PowerPoint, Adobe, and other software/web-based applications.
• Ability to facilitate meetings and presentations to large groups.
• Ability to work under minimal supervision; Ability to travel regionally to various locations.

Job Duties

• Timely completion of annual hospital and facility license renewals for the system, including tracking expiration dates and collecting onsite inspection reports to ensure new licenses are obtained, and ensures facility compliance with state-specific licensing standards and federal regulations, and remains knowledgeable on current federal and state regulations.
• Manages several licensing projects concurrently and ensures projects meet required standards assigned deadlines.
• Works with project stakeholders and external cohorts to collect required documents and information to complete licensing packets; communicates effectively and timely with key stakeholders about projects to resolve issues and meet deadlines.
• Facilitates project management meetings and ad hoc meetings, documents meeting notes, and completes related action items.
• Coordinates onsite physical environment surveys, preparing clinical and operational teams to ensure survey readiness, and reporting onsite to act as licensing lead during those onsite surveys.
• Applies for initial Medicare and Medicaid enrollments for new hospitals, facilities, and provider types.
• Maintains existing Medicare and Medicaid enrollments, updates and revalidates enrollments as need or as required by CMS; utilizes PECOS (Provider Enrollment, Chain, and Ownership System) database to submit new enrollment applications and to update existing enrollments.
• Administers CMS Physician Time Study, which occurs 2 weeks per quarter, for a total of approximately 2,000 physicians. That includes updating the online database with participant information, maintaining instructions and training tools, conducting group and individual training sessions, monitoring and encouraging timely submission from all participants, performing quality audits of submitted time studies, and preparing quarterly and annual reports.
• Administers CMS Lay Transplant Time Study, which occurs 1 week per month, for approximately 200 participants. That includes updating the online database with participant information, maintaining instructions and training tools, conducting group and individual training sessions, monitoring and encouraging timely submission from all participants, and preparing monthly and annual reports.
• Performs other related duties as required.

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.