Clinical Policy Compliance Specialist

Here, it's different. Come join us.

Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years.

Here, the nation's brightest nurses, physicians, scientists, researchers, therapists, and care providers are creating the future of child health. With an optimist's outlook, a trailblazing spirit, and a celebrated history, we're making new strides every day.

We've been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the best of the best pediatric hospitals with #1 rankings in Colorado and the region by U.S. News & World Report.

As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 11 specialty care centers, 1,300+ outreach clinics and more than 10,000 healthcare professionals representing the full spectrum of pediatric care specialties.

Here, we know it takes all of us, every role, to deliver the best possible care to each child and family we treat.

That's why we build our teams toward a foundation of equity in access, advancement, and opportunity. We know teams of individuals with different identities and backgrounds can nurture creativity and innovation. We know we can see, treat, and heal children better when our team reflects the diversity of our patient population. We strive to attract and retain diverse talent because we know a truly inclusive and equitable workforce will help us one day realize our most basic calling: to heal every child who comes through our doors.

A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Here, it's different.

The Clinical Policy Compliance Specialist (CPCS) works under the supervision of the Manager of Clinical Policy to provide direction and support in planning, organizing, implementing and evaluating clinical policies and procedures. Assists in translating regulatory/accreditation standards for team members. Establishes and maintains collaborative relationships with unit and system level leadership, subject matter experts, and departments focusing on evidence, regulatory standards, accreditation, patient safety, medication safety, informatics, and education to ensure quality document output and sustainability measures.

Department Name: Innovative Nursing Outcomes
Job Status: 64 Hours per pay period, eligible for benefits
Shift: Monday-Thursday, 8am-5pm

• EDUCATION - Bachelor of Science in Nursing (BSN).
• EXPERIENCE - Five (5) years clinical experience required, to include three (3) years of experience in nursing related regulatory and policy compliance. Pediatric nursing and/or healthcare operations experience preferred.
• CERTIFICATION(S) - BLS/CPR from the American Heart Association with at least 6 months left before expiration is required upon hire.
• LICENSURE(S) - Registered Nurse (RN) license.
  

***This position may require a BLS certification from the American Heart Association. Click on the following link and enter your zip code to find an appropriate class near you. Please note BLS (CPR cards) from organizations other than American Heart Association, even if it says it is AHA approved, will not be accepted.***

http://ahainstructornetwork.americanheart.org/AHAECC/classConnector.jsp?pid=ahaecc.classconnector.home

POPULATION SPECIFIC CARE

• No Direct Patient Care

ESSENTIAL FUNCTIONS
An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all the functions which the employee may be expected to perform.

• Ensures and facilitates all steps in the review approval to publication process of clinical policies and procedures are implemented.
• Oversees evidence-based clinical policies and procedures.
• Ensures all documents meet the defined standards.
• Leverages technology for retrieving, analyzing, and presenting data and results.
• Maintains record keeping of the policy content and stakeholder review and approval in the document management platform.
• Collaborates with unit and system level leadership, subject matter experts, and departments focusing on evidence, regulatory standards, accreditation, patient safety, medication safety, informatics, and education to ensure quality document output and sustainability measures.
• Responds to safety events or near misses via communication escalation and/or system channels (i.e., quality and safety reporting system) by identifying trends, investigating issues, resolving opportunities for clarity, and/or coordinating follow up in policy updates and/or development.
• Partners with department and system level leaders in ensuring staff maintain regulatory readiness and supports the organization with regulatory site visits.
• Translates regulatory/accreditation standards for team members (i.e., American Nurses Credentialing Center (ANCC), Magnet Standards, The Joint Commission, Centers for Medicare & Medicaid Services (CMS), Colorado Department of Public Health and Environment (CDPHE), etc.).
  

• Guidelines: Guidelines are generally numerous, well established, and directly applicable to the work assignment. Work assignment and desired results are explained by general oral or written instructions.
• Complexity: Duties assigned are generally repetitive and restricted in scope but may be of substantial intricacy. Employee primarily applies standardized practices.
• Decision Making: Decisions or recommendations on non-standardized situations are limited to relating organizational policies to specific cases. Brings non routine issues to supervisor. Problems that are not covered by guidelines or that are without precedent are taken up with the supervisor.
• Communications: Contacts with team members, clients or the public where explanatory or interpretive information is exchanged, gathered, or presented and some degree of discretion and judgment are required within the parameters of the job function.
• Supervision Received: Under normal supervision, within a standardized work situation, the employee performs duties common to the line of work without close supervision or detailed instruction. Work product is subject to continual review.

PHYSICAL REQUIREMENTS

• Audio-Visual: Color Discrimination: Good
• Audio-Visual: Far Vision: Good
• Audio-Visual: Hearing: Good
• Audio-Visual: Near Vision: Good
• General Activity: Sit: 7-8 hrs. per day
• General Activity: Stand/Walk: 1-2 hrs. per day
• Motion: Bend: Up to 1/3 of time
• Motion: Carry: Up to 1/3 of time
• Motion: Lift: Up to 1/3 of time

WORK ENVIRONMENT

• Equipment: phone, computers, reading reports/graphs.
• Mental and Emotional Requirements: Manages stress appropriately.
• Mental and Emotional Requirements: Works in close proximity to others and/or in a distracting environment.
• Mental and Emotional Requirements: Works with others effectively.
  

It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information.

Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development resources to help you advance and grow.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.