Clinical Operations Regulatory Specialist

• Associate's Degree in a related field preferred or Equivalent experience required.
• One year of Auditing in a managed healthcare system experience preferred.
• One year of Microsoft Office Suite experience required.
• One year of Medical Terminology experience preferred.
• Exceptional communication skills, both written and oral, ability to positively influence others with respect and compassion
• Strong work ethic built on a foundation of proactivity and teamwork.
• Ability to navigate ambiguity with the aid of structured problem solving techniques.
• Committed to the practice of inquiry and listening.
• Willingness to “roll up one’s sleeves” and embrace the nitty gritty, bottom up task of building an organization and implementing a new model
• Personal and professional track record that demonstrates a commitment to quality in health care
• A positive attitude: ability to work hard, have fun, and operate efficiently in a fast paced, start up, work environment and in a highly complex and dynamic movement for health delivery reform.
• Knowledge of regulations and statutory language and interpretation
• Strong communication and organizational skills with great level of attention to detail.
• Good listener, natural leader
• Facilitation skills at every level to ensure wide understanding and buy-in to business processes
• Demonstrated organizational skills, time management, detail orientation, flexibility and ability to work with minimal supervision.

• Work to develop and maintain complex audit processes and audit tools related to authorizations, appeals, quality, case management, inter-rater reliability and data entry
• Audit staff in accordance with established auditing processes and assist in making recommendations for improvement to the AVP Quality/Patient Safety Officer
• Work in conjunction with AVP Quality/Patient Safety Officer to establish patterns or trends that require additional training or corrective action
• Assist Training teams to incorporate audit findings into training programs
• Development of policy and procedures in relation to audit processes
• Assist with revisions to Policy and Procedure and/or work process development based on audit finding
• Actively suggests, implements, documents and participates in departmental quality improvement activities.
• Assures quality of care and services by adhering to industry standards and measuring health outcomes against patient care goals and benchmarks established by the organization.

• Paid Major Holidays
• Generous Paid Time Off / Vacation
• Sick Time
• Health Insurance
• Dental Insurance
• Undergraduate Student Loan Repayment
• Flexible Spending Accounts (FSA)
• Health Savings Account (HSA)
• Health Fitness & Education Class Discounts
• Employee Wellness Benefits
• Hospital Discount for Employees and Family
• VHC Retirement Program
• Tuition Reimbursement
• Free onsite parking
• Commuter Benefits
• Career Coaching
• Family Leave
• 401(k) + Match
• and much more!