Microsoft Office Suite
Nurse (Quality Assurance and Survey Certification), Health Insurance Specialist
Centers for Medicare & Medicaid Services (CMS)
08.2022 - Current
- Serves as principal contact for one or more State Survey Agencies, as assigned
- Recommends remedies, such as termination or other appropriate enforcement action of federally certified providers and suppliers, based on verified failures to meet the requirements
- Follow up with the provider and the survey agency (SA) to negotiate plans to resolve deficiencies and ensure corrective actions are taken
- Participates in SA program reviews and prepares formal reports to SA, summarizing strengths and weaknesses of SA operations and adherence to Medicare and Medicaid survey program policies and procedures
- Develops documentation to support the recommended action and serves as an advisor to the HHS Office of General Counsel (OGC) on legal issues arising from the enforcement action, which includes serving as the CMS representative in court, in the appeals process, and at other litigation procedures to present expert testimony
- Provides guidance and direction on survey issues to state agency (SA) staff, utilizing knowledge of principles and practice of nursing, identifies and resolves problems with SA survey performance, and coordinates activities with other state leaders at the Regional/Consortium level
- Maintains professional competence and provides technical expertise and guidance to other CMS survey/enforcement staff in conducting surveys and interpreting CMS regulations, policies, and survey processes, emphasizing quality healthcare delivery and nursing principles
- Represents CMS at meetings and seminars with government officials and non-government representatives concerning policies, projects, and data related to measurement and assurance of quality of care in care facilities for which CMS has oversight responsibility
- Serves as a resource to those states and providers with a continuing need for services
- Elicits the support of professional societies and other organizations in a state to resolve conflicts, controversies, and disputes over the applicability of Federal standards
- Advises other branches and components within CMS on interpreting and applying health care standards for different provider and/or facility types
