Complaints Investigator, Registered Nurse (HP III), CCAW- Complaints Section- HFEMSD

Job Title

Health Professional III

Job Description

The Work Unit: The Health Facilities and Emergency Medical Services Division (HFEMSD) oversees and enforces a wide range of federal and state regulations applicable to various health care facilities and services in Colorado. This division licenses, certifies, and surveys healthcare facilities and services; provides patient safety and healthcare quality programs; recognizes Emergency Medical Service (EMS) education programs and certifies EMS providers, designates trauma centers and licenses all air and ground ambulance services operating within the state of Colorado.

What You Will Do: The purpose of this position is to assess the care, treatment, and quality of life provided by health care facilities through observations, interviews, and record review. Uses experience, training, and judgment in evaluating and applying statutes, regulations, guidelines, policies, and procedures on a case-by-case, item-by-item basis for facility compliance/violation. Works as the RN required for the survey team, and conducts nursing observations and medication pass tasks, and other tasks as applicable. Reviews occurrences and incidents of serious deficiencies and assesses whether licensed health facilities intervened appropriately. Writes statements of deficiencies, identifying areas of non-compliance with federal and state requirements based on survey/investigation results. Acts as resource, educator, and interpreter of regulations for service providers and consumers, based upon established guidelines, policies and procedures.

• On an unannounced basis, independently or as a member of an interdisciplinary team, determines whether the entity is operating in compliance with applicable statutes/regulations.
• Assesses and evaluates health care facility/agency quality of care, services, and treatment of the residents/patients as well as facility practices through observation, record review, as interviews with residents/patients, family members, staff, and outside agency and medical professionals.
• RN serves as a clinical resource to determine whether the delivery of nursing care is in accordance with professional standards of practice and relevant state and federal requirements are being met.
• Writes clear, concise, and legally defensible statements of deficiencies based on analysis of the documented findings and extensive knowledge of these laws, regulations and guidelines as set forth in the Centers for Medicare and Medicaid Services (CMS) and State regulations, Principles of Documentation, and program specific protocols, policies and procedures, as applicable.
• Analyzes the data gathered during the investigation and, if substantiated, determines the appropriate regulatory citations to be issued.
• Advises, counsels and provides guidance to facility/agency administrators/staff regarding the purpose/reason for the regulations, and how to/or why areas are non-compliant.
• Advises health care facility/agency providers, health care consumers, and other governmental agencies regarding regulatory requirements.
• Attends meetings, serves on task forces or teams, completes projects, and performs other duties as assigned by the supervisor.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

Residency Requirement: This posting is only open to residents of the State of Colorado at the time of submitting your application.

Class Code & Classification Description: C7C3XX Health Professional III

Minimum Qualifications: NOTE: An applicant may meet the minimum qualifications for this job in one of two ways: They may qualify through their work experience alone or through a combination of education and work experience. Experience Only: Six (6) years of relevant experience in applicable health care in a facility or program regulated by the Health Facilities and Emergency Medical Services Division, experience in healthcare regulatory compliance or surveying, or other closely related experience and current, valid licensure as a Registered Nurse from the Colorado Board of Nursing or any state participating in the Enhanced Nurse Licensure Compact (eNLC). Or Education and Experience: A combination of related education in Public Health, Healthcare Administration, Nursing, Social Work, or closely related field, and/or relevant experience in applicable health care in a facility or program regulated by the Health Facilities and Emergency Medical Services Division, experience in healthcare regulatory compliance or surveying, or other closely related experience equal to six (6) years and and current, valid licensure as a Registered Nurse from the Colorado Board of Nursing or any state participating in the Enhanced Nurse Licensure Compact (eNLC).

You must substantiate that you meet the minimum qualifications when filling out the Work Experience section of the application. Failure to do so will result in the application not moving forward in the hiring process. "See resume" will not be accepted. Resumes are considered supplemental information and are not considered in the initial evaluation. In addition, part-time work will be prorated when determining whether minimum qualifications are met.

Supplemental Information

A complete application packet must include:

• Completed State of Colorado application.
• COVER LETTER: describing how your professional experience aligns with the preferred qualifications of this position.
• If using education to qualify for this position a copy of your transcripts (unofficial acceptable) or diploma must be provided with application. Transcripts must be attached to your colorado.gov/jobs application.
• If you are a veteran, a copy of your DD214 must be attached to your colorado.gov/jobs application.