Accreditation/Regulatory Specialist (Healthcare)

Job Summary
Provides oversight for coordination and execution of multiple and simultaneous projects using collaborative cross-functional teams. Develops, deploys, educates on SOP, and leads process improvement projects and huddle boards. Audits and monitors departmental licensing compliance and ensures training and licensure/certification compliance. Tracks and analyzes departmental requirements to ensure quality services for both internal and external customers consistent with organization's visions and values. Maintains stakeholders apprised on progress and gaps through the use of multiple communication venues such as in-person presentation, video recorded messages, or management/staff written communication.

Job Specific Duties

• Assists Leader with daily department operations and management including preparations for Accreditation and Regulatory surveys.
• Collaborates with departmental leaders for coordination of licensing needed under hospital system main campus and remote locations. Ensures compliance with all licensing requirements.
• Develops and manages the licensing management program (both new and renewal registration paperwork) utilizing standard work.
• Supports operational leaders and maintains accurate inventory of licenses within hospital application system.
• Ensures the timely submission of materials to local and state agencies in order to obtain licenses promptly and efficiently.
• Ensuring document or version control of licenses and certificates are accurate.
• Maintaining compliance to local, state, and federal accreditation and regulatory licensing and certification requirements.
• Conduct internal assurance audits of processes, policies, and protocols to identify process improvement measures within licensing and accreditation bodies.
• Oversees Accreditation and Regulatory Intranet department page, updating departmental news, and announcements.
• Investigates and works with departmental leaders on regulatory complaints to ensure timely response submission.
• Supports and participates on special project teams, including preparation of reports and implementation plans as requested by management. As management requests, leads special projects teams.
• Engages in planning and developing short-term and long-term departmental and interdepartmental projects as assigned.
• Creates an environment that empowers staff and embraces Lean culture. Provides resources as necessary to successfully complete projects and sustain process changes.

  Minimum Job Requirements

• Bachelor's Degree in Business, Healthcare, or related field required within one year in role
• Active Driver's License and valid State of Florida driver's license with an approved driving record pursuant to our policy and maintained throughout employment
• 3 years in an administrative environment
• 2 years in healthcare environment
• Intermediate level in Microsoft Word, Excel, PowerPoint, Share Point, and Outlook

 
Knowledge, Skills, and Abilities

• Analytical ability to perform assessments and evaluations.
• Regulatory communicates in a collaborative environment and provide verbal and written reports.
• Attention to detail.
• Maintaining compliance and staying up-to-date on regulatory policies.
• Time-management skills to prioritize work tasks and meet deadlines.
• Manages multiple work tasks, file reports, and analyze a lot of data.
• Computer skills needed to write reports using software programs and analyze digital files.