Job Information

YesCare Corp RN Auditor in Baltimore, Maryland

Experience & Requirements

  • Associates Degree in Nursing or higher. Experience with healthcare, analytics, internal audit or compliance required. Experience supporting quality assurance programs in any health setting with Corrections and Correctional health care preferred.

  • Thorough knowledge of court litigation/settlement/stipulation agreements and processes. 3+ years of experience in a litigation environment with demonstrated knowledge in court decrees with monitored stipulation agreements. Demonstrated ability to informally lead, influence, persuade or act as mentor. Knowledge of healthcare preferred.

  • Computer usage for word processing, spreadsheets, email, internet, medical records, grievances, claims, pharmacy and other proprietary company/client systems.

  • Utilizes tools to monitor systems and coordinates implementation performance improvement activities as indicated

  • Functions as a liaison between the medical, corrections, and legal communities to promote understanding of complex issues including any legally mandated stipulation agreements

  • Consistently monitors systematic adherence to policy and procedures and any legally mandated stipulations

  • Understands and communicates potential risk related to any legally mandated stipulations

  • Coordinates mitigating activities of complex issues that pose potential risk to Corizon and the DOC

  • Ability to read, analyze and interpret general procedures, professional journals and general business periodicals. Ability to write reports, business and legal correspondence and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, inmates, attorneys, and the general public.

  • Ability to work on extremely complex problems where analysis of situations or data requires an evaluation of intangible variance factors.

  • Work within areas of correctional facilities where conditions are not necessarily ideal or pristine. Correctional officers provide security; however, some degree of risk of verbal and physical assault from inmates exists. As in any healthcare setting, employees may be exposed to communicable and/or infectious diseases. Inside work with periodic travel (inter and intra state) to other locations. Some standing and walking while presenting or performing job duties.

  • Must have and maintain sufficient strength, agility, and endurance to perform using stressful (physical, mental and emotional) situations encountered on the job without compromising your health and well-being or that of your fellow employees.

A background check, security clearance and drug screening are required for this role.

Corizon Health is an Equal Opportunity/Affirmative Action Employer. In compliance with federal and state employment opportunity laws, qualified applicants are considered for all positions without regard to race, gender, national origin, religion, age, sexual orientation, disability, Vietnam era veteran, or disabled Veteran status. EOE including Disability/Protected Veterans.

Responsibilities

Under the general direction of the Strategic Compliance Manager, the Strategic Compliance Clinical Auditor (RN) collects, organizes, and tabulates information on healthcare services delivered on the health care unit as it pertains to the settlement agreement.

Below is a list of your responsibilities as an RN Auditor with Corizon Health:

  • In accordance with the settlement agreement executed by the plaintiff, gathers, organizes, and tabulates health care services data, performs chart reviews utilizing the EPHR, and paper health record, maintain a high level of knowledge and understanding of the settlement agreement, DPSCS, and company policies and procedures, including developed processes and clinical protocols

  • Supports the maintenance of audit results and supportive documentation records to comply with all sections of the settlement agreement.

  • Collaborates with site leadership and the custody partner to ensure effective and efficient corrective action plans are recommended and monitored with documented outcomes for non-compliant trends.

  • Analyze data and prepare monthly narratives as required by DPSCS. Perform all clinical reviews and adhere to the specified methodologies.

  • Attend CQI meetings for facilities associated with the settlement agreement as requested by DPSCS. Protects confidentiality of information in written and verbal communications and maintains compliance with HIPAA regulations.

  • Assemble, prepare and distribute site-level status reporting.

  • Participate in root cause analysis efforts.

  • Establishes and maintains positive relationships with the client.

  • Attends meetings as required.

  • Participates in quality improvement projects, which may include court decree stipulations and client contract requirements.

  • Assists in policy, procedure, and system development.

  • Performs follow-up evaluations to determine the effectiveness of actions taken to resolve deficiencies.

  • Other duties as assigned.

Corizon Benefits

  • Health, Dental and Vision Insurance

  • Life and Disability Insurance

  • Generous PTO plan

  • 401k with matching funds

  • Employee Discount and Rewards Program

  • Tuition Assistance

  • Continuing Education Reimbursement

About YesCare Health

Correctional healthcare is not just a job, it’s a calling!!!

As the correctional healthcare pioneer and leader for 40 years,YesCareprovides client partners with high quality healthcare and reentry services that will improve the health and safety of our patients, break the cycle of recidivism and better the communities where we live and work.

Benefits

  • Health, Dental and Vision Insurance

  • Life and Disability Insurance

  • Generous PTO plan

  • 401k with matching funds

  • Employee Discount and Rewards Program

  • Tuition Assistance

  • Continuing Education Reimbursement

  • Referral Bonuses – Refer a friend and get paid!

  • Advancement Opportunities

  • Competitive Wages

  • Performance Incentive

Our Vision

YesCareleads the industry by providing comprehensive healthcare and reentry services that improve the communities where we live and work.

Our Mission

YesCareembraces a recovery model of care. This means identifying and treating underlying conditions to support healthier and safer living while incarcerated and a better quality of life in our communities. In partnership with our clients, we deliver

solution-oriented care.

Our Values

  • Safety. We put safety first through preparation and prevention.

  • Motivation. We are driven by the desire to improve outcomes.

  • Accountability. We set high standards and hold our people to them.

  • Respect. We embrace our differences as we work toward common goals.

  • Teamwork. We achieve more together.

  • Evaluation. We use data to constantly monitor results.

  • Readjustment. We refine our practices to consistently achieve better outcomes.

Apply today at: Careers.yescarecorp.com

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ID 2022-11752

Job Locations US-MD-Baltimore

Category Healthcare Support

Position Type Regular Full-time

Shift / Schedule Day

Location ID 91202