Adverse Action Adjudicator

Adverse Action Adjudicator | HCA Healthcare

General Position Information

Reports directly to (Title):

Manager, Business Process Administration

Matrix reports to (Title):

AVP, HR Shared Services

Direct Reports:

N/A

Created / Last Revised:

12/08/2026

Job Code:

TBD

Position Summary:

Reviews the position requirements associated with each case, including minimum qualifications and required pre-employment verifications, together with candidate disclosures, consent forms, resumes, and background investigation results to determine whether requirements are met and information aligns. Applies the established adjudication matrix and renders objective, impartial decisions based on the facts presented. The Adverse Action Adjudicator must remain neutral and free of conflicts of interest while determining whether discrepancies, omissions, or unmet requirements are sufficient to disqualify a candidate from employment.

Responsibilities:

Major Responsibilities

• Review the position requirements associated with each case, including minimum qualifications and required pre-employment verifications, and compare them with the candidate's consent form, resume, disclosures, and background investigation results to confirm alignment and completion.

• Evaluate discrepancies or omissions between information disclosed by the candidate and information verified through the background investigation, including whether nondisclosure affected the scope of screening, and apply the established adjudication matrix to determine the appropriate course of action.

• Consult with the background investigation vendor and/or the subject of the investigation, as needed, to clarify relevant facts and circumstances.

• Render approval or denial decisions in accordance with the adjudication matrix and, as applicable, relevant laws, regulations, policies, precedent, and informed assessment of potential risk to the employer.

Governance & Compliance

• Periodically review the adjudication matrix used by Recruiting and recommend revisions as appropriate.

• Create and maintain complete records of adjudication decisions, including the rationale supporting each course of action.

• Develop and maintain adjudication analytics to support reporting and informed decision-making.

• Safeguard the confidentiality of all adjudication materials and related information.
• Recommend improvements to adjudication processes, products, and services.

• Exercise independent judgment and operate with minimal supervision in a complex environment.

• Conduct investigations and recommend resolutions in collaboration with Legal, Ethics and Compliance, Human Resources Business Partners, and other stakeholders as appropriate.

• Monitor emerging business challenges and regulatory developments that may affect adjudication practices.

Other

• Perform other duties as assigned.
• Adhere to HCA Healthcare's Code of Conduct, Mission, and Values.

Education & Experience:

• Bachelor's degree (required)
• Minimum of 1 year of relevant professional experience (required)

Must Have Skills

• Demonstrated ability to solve unique and complex problems with broad business impact
• Proficiency with computers and business software applications
• Strong proficiency in Microsoft Office, including Outlook, Word, and Excel
• Strong written communication skills

Nice to Have Skills

• N/A

Licenses, Certifications & Training:

• N/A

Knowledge, Skills, Abilities, Behaviors:

Service and Quality Excellence: Demonstrates an unwavering commitment to delivering exceptional care and creating an unmatched value proposition for patients.

Required

Honor our Mission and Values: Builds trust and acts authentically to foster a culture of integrity, inclusion, and mutual respect.

Required

Effective Decision Making: Makes timely, informed decisions that support the best interests of patients, employees, providers, the community, and HCA.

Required

Attain and Leverage Strategic Relationships: Develops and strengthens collaborative relationships with internal and external stakeholders to advance patient care and support the growth of HCA.

Required

Lead and Develop Others: Leads others to achieve organizational goals and objectives while providing meaningful coaching and mentoring to strengthen individual and team capabilities and drive employee engagement.

Required

Communicate with Impact: Communicates information clearly, concisely, and persuasively to engage others effectively and achieve desired results.

Required

Achieve Success through Change: Identifies opportunities for improvement and innovation, addresses barriers and resistance, and enables desired behaviors.

Required

Drive Execution and Financial Results: Demonstrates commitment to HCA's success and financial well-being by setting high standards and holding self and others accountable for achieving results.

Required

Strategic Positioner: Positions the business for sustained success within its market.

Required

Credible Activist: Builds trusted relationships through a proactive, informed point of view.

Required

Paradox Navigator: Effectively manages competing business priorities and tensions, balancing long- and short-term needs as well as top-down and bottom-up perspectives.

Required

Culture and Change Champion: Drives effective change and supports the management and evolution of organizational culture.

Required

Human Capital Curator: Manages the flow of talent by developing employees and leaders, driving individual performance, and building technical capability.

Required

Total Reward Steward: Supports employee well-being through the effective use of financial and nonfinancial rewards.

Required

Technology and Media Integrator: Uses technology and social media to enable and strengthen high-performing organizations.

Required

Analytics Designer and Interpreter: Uses analytics to improve the quality and effectiveness of decision-making.

Required

Compliance Manager: Manages compliance-related processes in accordance with applicable regulatory guidelines.

Required

Preferred candidate profile

Perks and benefits