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Manager Rehab-Regulatory and Compliance

Job ID JR131537 Date Posted 11/22/2022
San Diego, California
  • Rehab Center
  • Day
  • Regular
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Responsibilities

Hours

Shift Start Time:

8 AM

Shift End Time:

4:30 PM

Additional Shift Information:

Weekend Requirements:

As Needed

On-Call Required:

No

What You Will Do
Accountable for the ongoing development and compliance with regulatory requirements (including CARF, CMS and TJC), maintaining the quality of care within work unit(s) and/or programs. Assists Director with operational planning and provides daily work direction to achieve unit level of care and organizational objectives.

Contributes to budget development and maintains responsibility for achieving budgetary objectives through establishing operational efficiencies. Is responsible for managing all administrative functions for rehabilitation and therapy areas as assigned.

Required Qualifications

  • Bachelor's Degree in Nursing, Occupational Therapy, Physical Therapy, Social Work or Speech Language Pathology.
  • 3 years management/supervisory experience
  • California Registered Nurse (RN) - CA Board of Registered Nursing OR Occupational Therapist Registered (OTR) - National Board for Certification in Occupational Therapy OR California Licensed Physical Therapist (PT) - CA Physical Therapy Board OR Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) - The American Speech-Language-Hearing Association (ASHA) OR California BBS Licensed Clinical Social Worker (LCSW) - CA Board of Behavioral Sciences -REQUIRED


Preferred Qualifications

  • Master's Degree in Nursing, Occupational Therapy, Physical Therapy, Social Work or Speech Language Pathology.


Essential Functions

  • Key Responsibilities:
    Provides oversight for the agency's regulatory compliance services, including TJC, CARF, CMS, Title 22 regulations and all other appropriate professional organizations, accrediting bodies and regulatory agencies. Oversees compliance with regulatory changes.
    Directs activities to ensure delivery of high quality, cost-effective care according to patient needs, physician orders, and in compliance with applicable regulations.
    Collaborates with the clinical educators and leadership team to assure all staff receives appropriate ongoing education regarding regulatory compliance.
    Monitors IRF case mix and resource utilization.
    Coordinates the organization of Medical Records to be submitted for review by insurance companies and government agencies. Ensures all documentation is present in the Medical Records for review, reviews all IRF and OP Rehab denials and follows appeals process to completion.
    Provides leadership in the planning, development, coordination and implementation of regulatory compliance activities, including QA, UR and PPS. Includes policies. procedures and processes.
    Responsible for the organization of quarterly/yearly outcome reports for IRF. Will ensure clinical managers are educated on the data presented and ensure this data is presented to staff. All data is organized and presented meeting accrediting agency requirements.
    Responsible for the oversite of all regulatory requirements for collection and input of data for IRF-PAI to ensure maximum reimbursement. Ensures the timely transmission of patient data to IQIES to avoid any financial penalties. Oversees the accurate input of patient data in the UDS PRO system; uploading and downloading reportable information to ensure timely benchmarking of data against Regional and National Rehab Facilities.
  • Quality:
    Assure productivity and quality measures are tracked and maintained.
    Develops and maintains departmental records, reports and patient records; collects statistical data is required.
    Maintains professional growth and development.
  • Safety:
    Maintains department facilities and equipment in a condition to promote efficiency; health, comfort, and safety of patient and staff; evaluates and justifies equipment and supply needs and purchases; negotiates and documents maintenance schedules; plans for use of space, purchasing new equipment and outside programs. Establishes and maintains safety, infection and environmental control policies and procedures for the department.
  • Service:
    Exemplifies, supports and advocates the principles, standards, goals and strategies of the Sharp Experience.
    Plans, organizes and manages departmental activities for the treatment of patients; develops goals and objectives, establishes and implements policies and procedures for department and system operation; develops programs in the field to meet current needs; reviews department performance, effects changes as needed to improved services provided and assures compliance with regulatory requirements; keeps administration informed of department activities, needs and problems’ establishes system for charging and billing.
    Identifies patient needs and ensures development of therapy and business programs to meet these needs; assures the delivery of quality services to inpatients and outpatients; is available for consultation with medical, nursing and administrative staff; manages case load and therapist hours to suit needs of patients and institution. Develops and maintains continuous quality improvement records and processes of the assigned departments; introduces and demonstrates new techniques and equipment to the staff; meets regularly with nursing staff for optimal clinical care delivery.
    Compliance with internal standards, regulatory and accreditation bodies.
    Assume 24-hour responsibility and accountability of unit(s)/program(s)/discipline department(s), supervised.
    Responsible for the selection, training, orientation and assignment of department staff; develops standards of performance and monitors and supervises staff; evaluates performance and initiates or makes recommendations for personnel actions such as merit increases, promotions and disciplinary action; encourages professional development of department personnel through in-service education and outside conferences; develops and maintains job descriptions for all staff members; resolves staff grievances.
    Perform all other duties as assigned.
  • People:
    Attain patient satisfaction scores greater that the 90th percentile, as measured by Press-Ganey or the most current system used to measure patient satisfaction as required and appropriate.
    Supervises staff including hiring, coaching and counseling. Write and conduct performance appraisals are within system deadlines.
    Promote staff accountability and empowerment through formal and informal mechanisms.
  • Finance:
    Develops and recommends department operating budget and ensures that departments operate within allocated funds; maintains department reports and statistics for administrative and regulatory purposes; consults with administration concerning capital expenditures.
  • Growth/Community:
    Collaborate with Marketing regarding the development, marketing, implementation and evaluation of programs.
    Participates in administrative strategic planning, staff meetings and attends other meetings as assigned; establishes and maintains communication within the department and with other hospital departments, develops relationships with community agencies, groups, professional affiliations as is appropriate; ensures that departments are represented at conferences and working committees.


Knowledge, Skills, and Abilities

  • Experience demonstrating and enhancing quality care and compliance with internal standards and regulatory and accreditation bodies, just as CARF, CMS and TJC.
  • Knowledge of fiscal and budgetary principles/practices required.
  • Knowledge of Microsoft Office, Word and Outlook required.
  • Managerial/Supervisory skills – Lead by example. Demonstrated ability to remain flexible in rapid change environment and current health care dynamic climate. Two or more years in a leadership position. Demonstrated ability to plan, design and implement one's own work and to work independently with minimal observation or supervision.
  • Human Relations skills – Able to meet service excellence for others. Demonstrated ability to communicate clearly and effectively and to work collaboratively with multiple others of diverse cultures, education background, experience, etc. Demonstrated knowledge of team building skills and principles of self-managed work teams. Must demonstrate excellent oral and written communication and interpersonal skills.
  • Political Process skills - Ability to function well under condition of current environment; ability to collaborate with others, and to consider conflicting viewpoints. Ability to build partnerships with physicians and other key stakeholders

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

California Licensed Physical Therapist (PT) - CA Physical Therapy Board; Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) - The American Speech-Language-Hearing Association (ASHA); California BBS Licensed Clinical Social Worker (LCSW) - CA Board of Behavioral Sciences; Bachelor's Degree; Master's Degree; California Registered Nurse (RN) - CA Board of Registered Nursing; Occupational Therapist Registered (OTR) - National Board for Certification in Occupational Therapy
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