Remote Utilization Review Rn Jobs in Warren, MI (NOW HIRING)

CorsoCare Hospice

Job Title: Compliance Manager - RN
Job Status: Full-Time
Location: Milford Office/Hybrid

At CorsoCare we offer:
Employee First Benefits:
• Competitive compensation, including Medical (BCBS), Dental, Vision and an HSA
• Continued Growth and Education from training, supportive leadership, and collaboration
• Generous PTO, Holiday and Sick Pay
• A company provided tablet with 24/7/365 IT support
• Tuition Reimbursement up to $2500 per year
• Pet Insurance

Employee First Culture - YOU BELONG, YOU MATTER!
• What makes you different, makes us great
• You are part of a team
• Your unique experiences and perspectives inspire others
• A 1440 Culture - one that strives to use all 1440 minutes in each day to create the absolute best experiences with every person, in every interaction

Position Summary:

The Clinical Compliance Manager position is responsible for executing clinical compliance audits, monitoring regulatory adherence, and supporting survey readiness across assigned hospice locations. This role identifies compliance risks through medical record review, operational audits, regulatory monitoring, and branch mock audits and works collaboratively with clinical leadership to implement corrective actions.

The Clinical Compliance Manager translates audit findings into practical education and coaching for clinical staff, ensuring sustained compliance with CMS Conditions of Participation, accrediting body standards, and applicable state and federal regulations.

Required Experience:

• Registered Nurse (RN) license, active and in good standing.
• Minimum of 6-8 years of hospice experience.
• Working knowledge of CMS Conditions of Participation and accreditation standards.
• Experience with medical record review, audits, or quality/compliance activities.
• Strong clinical documentation skills and attention to detail.

Preferred Experience:

• Experience in hospice compliance, quality, or survey preparation roles.
• Multi-state hospice experience (Michigan, Ohio, Indiana preferred).
• Prior participation in surveys, audits, ADRs, or corrective action processes.
• Compliance or quality certification (e.g., CHC, CHPC, CHPN) preferred but not required.

Responsibility for Clinical Compliance Manager:

• Conduct routine, focused, and for-cause clinical compliance audits in accordance with established audit tools and methodology.
• Perform detailed medical record reviews to assess compliance with CMS Conditions of Participation, accreditation standards, and internal policies.
• Identify documentation gaps, regulatory risks, and patterns of non-compliance across clinical disciplines.
• Maintain accurate, timely audit documentation and tracking to support trend analysis and reporting.
• Analyze audit findings to identify systemic issues, repeat deficiencies, and areas of elevated compliance risk.
• Collaborate with clinical leadership to develop corrective action plans that are practical, measurable, and sustainable.
• Monitor corrective actions through completion and validate effectiveness through follow-up audits.
• Escalate high-risk findings and unresolved issues to the Regional Director of Compliance and Denial Management.
• Translate audit findings into targeted, role-specific education for clinical staff and leaders.
• Provide real-time coaching and mentoring to clinical staff related to documentation standards and regulatory expectations.
• Participate in the development and delivery of compliance education related to audit outcomes, regulatory changes, and survey readiness.
• Reinforce best practices for defensible, audit-ready clinical documentation.
• Support ongoing survey readiness activities across assigned locations.
• Participate in mock surveys, tracers, and focused reviews as directed.
• Serve as a compliance resource during surveys, audits, ADRs, and regulatory inquiries.
• Assist in preparation of documentation and responses related to audits, surveys, or investigations.
• Work collaboratively with Quality/ Education, Clinical Operations, and Leadership teams to support compliance initiatives.
• Communicate audit findings and expectations clearly, professionally, and in a non-punitive manner.
• Provide routine updates and reports to the Regional Director of Compliance and Denial Management regarding audit results, trends, and risk areas.

Skills for Success:

• Clinical documentation review and regulatory interpretation
• Audit execution and issue identification
• Education and field coaching
• Professional communication and collaboration
• Organization, time management, and follow-through
• Ability to work independently in a remote environment

General Working Conditions:

This position entails sitting for long periods of time. While performing the duties of this job, the employee is required to communicate effectively with others, sit, stand, walk and use hands to handle keyboard, telephone, paper, files, and other equipment and objects. The employee is occasionally required to reach with hands and arms. This position requires the ability to review detailed documents and read computer screens. The employee will occasionally lift and/or move up to 25 pounds. The work environment requires appropriate interaction with others. The noise level in the work environment is moderate. Ability to wear Personal Protective Equipment (PPE).

• Primarily remote with travel to assigned hospice locations as needed.
• May require availability during surveys, audits, or regulatory events.

This classification description is intended to indicate the general kinds of tasks and levels of work difficulty that are required of positions given this title and should not be construed as declaring what the specific duties and responsibilities of any particular position shall be. It is not intended to limit or in any way modify the right of any supervisor to assign, direct and control the work of the employees under her/his supervision. The use of a particular expression or illustration describing duties shall not exclude other duties not mentioned that are of a similar kind or level of difficulty.

Equal Opportunity Employer

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