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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in developing and monitoring nursing clinical programs while ensuring compliance with State and Federal regulations for Medicare and Medicaid. Proficient in training, oversight, and risk management within healthcare settings.
Highest-signal resume keywords
Bachelor's Degree In Nursing20+ Years Of Clinical And Management ExperienceMDS Certified ExperienceLegal Nurse Consultant ExperienceCMS/OIG Survey Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical Program DevelopmentCompliance MonitoringRisk AnalysisReport WritingData InterpretationAudit Medical RecordsClinical TrackingStaff TrainingPlans Of CorrectionHealthcare Regulations
Soft Skills
Effective CommunicationProblem SolvingLeadershipTraining And EducationInterpersonal Skills
Tools & Technologies
Microsoft Office SuitePayroll SystemsHuman Resource SystemsMDS SystemsClinical Reporting Tools
Certifications & Qualifications
Professional In Human Resources (PHR)SHRM Certified Professional (SHRM-CP)
Industry Keywords
MedicareMedicaidCMSOIGJeopardy CitationsRisk ManagementClinical OversightHealthcare ComplianceNursing ManagementRegional Nurse Experience
About the role
Key responsibilities & impact- Develop, implement, educate, and monitor nursing clinical programs
- Ensure facilities follow State and Federal Survey Regulations for Medicare and Medicaid licensure certification
- Assist with plans of correction and allegations of compliance for survey deficiencies
- Monitor facility compliance with submitted plans of correction
- Oversee reportable events submitted to the Office of Inspector General
- Provide training to facility administrators and staff
- Assist with hiring, training, and disciplinary actions for Directors of Nursing
- Conduct monthly Regional DON meetings
- Create and establish Regional clinical, MDS, dietary, social services, and regulatory policies
- Assist DONs with staffing structure and nursing PPD
- Visit facilities to assess, train, and monitor administrative staff; create action plans as needed
- Attend Regional Operations and other Regional meetings
- Provide oversight and direction to the MDS department
- Educate facilities on Medicare and Medicaid utilization and reimbursement in case-mix states
- Monitor Myers and Stauffer reports and assist in case-mix index development
- Conduct Regional monthly MDS meetings
- Monitor and assist with RAC audits
- Assist facilities with Human Resource issues
- Develop clinical tracking and trending reports for CMS 5-star ratings
- Develop clinical reports monitoring high-risk liability areas
- Work with liability insurance company visits, plans of correction, and high-risk concerns
- Assist Regional or company defense attorneys with lawsuits, depositions, reports, and document production
- Review record requests and notify leadership and attorneys of adverse events or liability concerns
- Audit medical records and write preliminary reports or risk analyses
- May act as an onsite Interim DON
- Provide supervision responsibilities and clinical oversight
Requirements
What you’ll need- Bachelor's Degree in Nursing (BSN) or equivalent Accredited Nursing Program Degree
- 20+ years of Clinical and Management experience preferred
- MDS certified experience preferred
- Legal Nurse Consultant or Risk Management experience preferred
- Previous Regional or Corporate Nurse experience preferred
- Experience with CMS/OIG surveys including Jeopardy citations preferred
- PCC knowledge
- Ability to read, analyze, and interpret business periodicals, professional journals, technical procedures, or governmental regulations
- Ability to write reports, business correspondence, and procedure manuals
- Ability to effectively present information and respond to questions from managers and employees
- Ability to apply fractions, percentages, ratios, and proportions to practical situations
- Ability to solve practical problems and interpret written, oral, diagram, or schedule instructions
- Above average knowledge/skills in Microsoft Office Suite, payroll systems, and human resource systems
- Travel by auto or airline required at least 25% of the time
- Ability to occasionally lift or move up to 25 pounds
- Prolonged use of a desktop or laptop computer
- Professional in Human Resources (PHR) or SHRM Certified Professional (SHRM-CP) preferred