A&RA Principal Advisor

JOB SUMMARY:

Under the leadership of the UVMHN AVP Accreditation and Regulatory Affairs Chief Regulatory Officer Accreditation, the Accreditation and Regulatory Affairs Principal Advisor assists with the implementation of the UVMHN regulatory program to assure that an effective and comprehensive regulatory and accreditation readiness program is in place. This program includes but is not limited to compliance with the TJC (Joint Commission) Accreditation Guidelines, CMS Conditions of Participation, Long Term Care, Home Health Disease Specific Certifications, Program specific accreditations and other state and federally mandated regulatory agency guidelines as appropriate. With the support of the Leader, the incumbent is responsible for implementation of key regulatory readiness strategies that promote effective compliance with state and federal standards. Reviews and assimilate JC and DOH standards, and CMS conditions of participation for requirements, and other regulatory bodies and expectations for compliance. Compare and contrast for differences, if conflict - determine which to integrate into UVMHN policies and operations.

This role functions as the system advisor / author for the following network systems: UVMHN Document Management System for organization Policies and Procedures and the UVMHN Regulated Mandatory Education Content.

EDUCATION:

Bachelor of Science in Health Care Related Field / RN or Legal Field. Master’s degree preferred.

EXPERIENCE:

• Experience in a healthcare environment and experience with interpretation and evaluation of accreditation standards is preferred.

• Five years or more of increasing responsibility in systems, quality, or health care administration

• Demonstrated management ability

• Strong communication/presentation skills

• Ability to work with all levels of staff and management

• Previous experience with JC/regulatory agency preparation, coordination, education and surveys for hospitals, physician office practices, home health care and free-standing ambulatory surgery settings

• Previous experience with electronic document management systems (desirable)