Compliance Reviewer - Inspector VI

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.

Brief Job Description:

If you are looking for a place to work where you can establish a career that is filled with purpose, this is the job for you!

Compliance Reviewer – Starting Market Rate Salary $65,556.57

Under the supervision of the Regional Coordinator, the Compliance Reviewer monitors and tracks all surveys completed in the region for regulated programs such as Nursing Facilities (NF), Assisted Living Facilities (ALF), Prescribed Pediatric Extended Care Centers (PPECC), Intermediate Care Facilities (ICF) and Day Activity Health Services (DAHS), Life Safety Code (LSC), Home and Community Support Service Agencies (HCSSA), and Home and Community-based Services and Texas Home Living (HCS/TxHML) waiver programs. This position participates in regional enforcement reviews and makes state and federal enforcement decisions. The Compliance Reviewer provides consultation and guidance in development and revision of NF, ALF, DAHS, ICF, LSC, HCSSA, HCS/TxHmL, and PPECC statewide enforcement related policies. The Compliance Reviewer provides professional regulatory feedback to surveyors, program managers, other state office level program staff. May assist Regional Director (RD), Assistant Regional Director (ARD), and Regional Coordinator (RC) in regulatory decision-making.

This position may communicate with Center for Medicare and Medicaid Services (CMS) related to enforcement. The Compliance Reviewer communicates with internal staff to ensure consistency of enforcement information. May be a witness at hearings. Participates in work groups, committees, and meetings as the enforcement representative. Reviews certification, licensure, and all other long-term care onsite visit reports for compliance with state laws, regulations, and policies and procedures. Assures reports follow established protocols and are accurately documented. Reviews and verifies information documents and data entry performed by others. Participates in review committees, prepares analysis of data for review and identification of staff training needs. Assists RC or conducts referrals.

This position offers a competitive starting salary; excellent state benefits, including health insurance and retirement; and the opportunity to regularly travel to different facilities within a region.

Essential Job Functions (EJFs):

Develops and maintains enforcement tracking system for enforcement reviews.
Monitors and tracks survey processes from exit through quality assurance and enforcement reviews to include notifications to the facilities.
Reviews and analyzes survey findings to determine if evidence supports a deficiency/violation and the assigned scope and severity.
Makes state and federal enforcement recommendations.
Provides consultation and guidance in the development and revision of facilities regional enforcement related guidance.
Provides guidance to regions and state office regulatory staff on enforcement issues by interpreting policies, regulations, rules and state and federal guidance letters.

May participate in enforcement reviews.
Provides clarification to regional staff to ensure strength of future deficiencies resulting in remedies being imposed.

Communications with Center for Medicare and Medicaid Services (CMS) for directives and guidance related to specific enforcement cases.
Assists RC or conducts referrals of facility staff to appropriate board/agency.
Reviews draft policies and guidance to ensure they conform to federal and/or state requirements as applicable.
Consults with internal stakeholders to ensure that consistent enforcement-related information is provided statewide.
Participates in workgroups, committies and meetings as the nursing facility enforcement representative.

May be a witness at hearings.
Responds to management, media, and legislative inquiries as appropriate.
Compiles monthly reports of facilities enforcement activities noting patterns and trends.

Knowledge, Skills and Abilities (KSAs):

Knowledge of state and federal laws and rules related to one or more of the above-named program areas. Familiar with updated internal memoranda and program guidance.
Familiar with ASPEN and  TULIP software programs with willingness and ability to learn new software programs.
Knowledge of state and federal laws and rules related to long-term care providers.
Knowledge of enforcement actions, survey and program activities related to the mentioned areas.
Knowledge of the State Performance Standards as mandated by CMS. Knowledge of applicable agency program policy and monitoring systems.

Skilled in the use of computers and applicable software including Microsoft Word, Outlook, TEAMS, SharePoint, and Excel programs.
 

Ability to gather, organize and analyze facts; to compile and prepare reports; to develop and evaluate policies and procedures and initiate modifications or revisions as appropriate.
Ability to interpret policies, rules, and regulatory language. Ability to communicate (verbally and written) with leadership, agency staff, stakeholders, and the public. Ability to adjust work routine according to priorities.
Ability to establish and maintain professional and effective working relationships. Ability to interpret policies, procedures, and regulations.
Ability to work independently.
Ability to exercise professional judgment and reach sound decisions.
Ability to integrate complex concepts into difficult procedures, or complicated processes. Ability to multi-task and track multiple activities with competing priorities

Registrations, Licensure Requirements or Certifications:

Must have Surveyor Minimum Qualifications Test (SMQT) Certification or obtain within 12 months of hire.

Initial Screening Criteria:

A Bachelor’s degree from an accredited college or university in a human service field (including but not limited to sociology, education, social work, psychology, rehabilitation, counseling, humanities, allied health, behavioral science, early childhood intervention, and medical administration). A combination of work experience and education may substitute for a Bachelor's degree.
Experience interpreting or overseeing compliance with state and federal licensure regulations and standards preferred.
Work experience in regulated facilities, including regulatory services, is preferred. 

Experience in any Long-Term Care Regulatory program. (Home Health, ICF/IID, Health Facilities, or Assisted Living Facilities and/or DAHS)

Additional Information:

Flexibility in work hours is required for this position. The job requires 35% travel, with most travel during the day. However, some overnight and weekend travel is required, as well as occasional on-call duties for emergencies or high-priority situations in facilities. Must have reliable transportation.

Note: This position is able to work a compressed workweek with options Monday-Thursday, Tuesday-Friday, and Friday-Monday, 10-hour days.

All applicants must pass a fingerprint criminal background check.

If you are an active or former licensed nursing facility administrator, certified nurse aide, or medication aide, hiring will be pending until professional licensing and Employee Misconduct Registry checks are completed.

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Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form