Investigator VI Job Description: Investigator VI Investigator VI Performs highly advanced (senior-level) investigative work for health facility regulatory program. May work independently or be assigned as member of specialized, interdisciplinary team to respond to statewide Regulatory investigative work. Work involves the triage, planning, organizing, scheduling and conducting of investigations at health care facilities throughout the state of Texas. May plan, assign, or review the work of others. Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment. Under the supervision of the Assistant Regional Director or Program Manager, participates as a team member or team coordinator conducting investigations in Long Term Care facilities to determine compliance with state and federal laws, regulations, and rules. Completes investigations reports listing deficiencies/violations which support the actions and remedies recommended. Narratives reports must meet CMS Q-9 five criteria.
Essential Job Functions:
Essential Job Functions: Task 1: Conducts investigations using applicable protocols, state and federal regulations, and appropriate policies and procedures for either the Geriatric, ICF/IID, ALFs, DAHS, or HCSSA programs. These include CMS State Operations Manual (SOM), Nursing Facility Requirements for Licensure and Medicaid Certification, the Assisted Living Facilities Licensure Inspection Handbook, Day Habilitation and Health Services Requirements, and the Long Term Care-Regulatory Investigation Handbook. Investigative procedures should be conducted in an effective, thorough and professional manner. • Meet the standards set forth in the investigations Handbook, and CMS guidelines (SOM) for completing forms correctly. • Follow applicable protocols, state/federal regulations and appropriate policies and procedures as determined by managerial and/or quality assurance review. • Maintain an up to date knowledge base regarding rules, standards, and other requirements. • Communicate with manager on an ongoing basis to assure that all pertinent information is shared promptly. Task 2: Assumes responsibility for coordinating all aspects of the investigation to ensure that procedures, policies, and protocols are followed for either the Geriatric, ICF/IID, ALFs, DAHS, or HCSSA programs. • Ensure that protocols, policies, and procedures are followed. • May schedule investigations for self and/or others in a manner that ensures timely completion as set forth in the Investigation Handbook and SOM. Task 3: Prepares descriptive and comprehensive reports that ensure compliance with State and Federal performance standard criteria for either the Geriatric, ICF/IID, ALFs, DAHS, or HCSSA programs. • Meets Performance standards as set forth in the Investigation Handbook and SOM. • Writes deficiencies that meet the principles of documentation criteria. • Ensure that documentation if submitted for review within mandated time frames. • Determines scope and severity that reflects the extent of the deficient practice. • Participate and attend enforcement meetings. Task 4: Provides effective professional testimony at formal hearings for either the Geriatric, ICF/IID, ALFs, DAHS, or HCSSA programs. • Meets standards for testimony as set forth in departmental guidelines. • Propose defensible decisions and recommendations to the Program Manager and enforcement Committee. • Comply with departmental policies and procedures which include guidelines regarding employee conduct. Task 5: Meets manager expectation for quality of performance for either the Geriatric, ICFIID, ALFs, DAHS, or HCSSA programs. • Attend 100% of mandatory training and immediately communicate attendance difficulties to the Program Manager for purposes of rescheduling. • If applicable, complete all requirements for and maintains a current professional license in good standing. • Provide copies of certificates of completion (or other proof) for all external training attended and required continuing education. • Willingness to travel to other areas of the state outside of geographic region on both individual and group investigative assignments. • May develop and conduct training. • Performs related work as assigned. Task 6: Responds to request for information for either the Geriatric, ICFIID, ALFs, DAHS, or HCSSA programs. • Provide consultation to other team members as requested. • Respond to request for information in a timely manner, including email requests. • Follow appropriate internal and external communication procedures. Inform manager and/or appropriate regional administrative staff immediately of significant program issues.
Knowledge Skills Abilities:
Knowledge Skills Abilities: Knowledge of investigative principles, techniques, and procedures; and of court procedures, practices, and rules of evidence. Must have knowledge of federal programs including Medicare, Medicaid, and the associated certification options. Must have knowledge of services provided in medical model settings and in community based settings. Skill in the operation of technical equipment and detection devices. Ability to plan, organize, and conduct investigations; to interpret and apply laws and regulations; to conduct interviews and gather facts; to evaluate findings; to prepare reports; to testify in hearings and court proceedings; to communicate effectively; and to assign and/or supervise the work of others. Effective use of time management for the timely and thorough completion of assigned investigations.
Registration or Licensure Requirements:
Registrations, Licensure Requirements or Certifications: Experience in investigative work. Graduation from an accredited four-year college or university with major course work in criminal justice or a related field is generally preferred. Experience and education may be substituted for one another. Must meet criteria to become a federal qualified (CMS SMQT testing) health facility surveyor within one year of employment.
Initial Selection Criteria:
Initial Screening Criteria: Initial Screening Criteria: 1. Knowledge of investigative principles, techniques, and procedures. 2. Knowledge of report writing. 3. Knowledge of operating personal computers and software. 4. Knowledge of medical terminology, medical background, and experience in investigations. 5. Experience in, or knowledge related to, the administration of and provision of care in long term care facilities including: Nursing Facilities, Assisted Living Facilities, Day Habilitative and Health Services, Intermediate Care Facilities for Mental Retardation, Home Health, and Hospice.
Additional Information: Note: Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to: 31B, 31D, EOD, 401, 5819, 7S0X1. All active duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information see the Texas State Auditor’s Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx. req#368010
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In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.