Quality Assurance Specialist Home Health

Description

We are seeking an experienced Home Health Registered Nurse with strong clinical judgment and a passion for accuracy, education, and process improvement to join our Quality Assurance (QA) team. This hybrid role offers the perfect blend of independent work, collaboration, and the opportunity to help elevate clinical quality across our organization.

Ideal candidates will bring strong working knowledge of OASIS and CMS home health regulations and previous experience using Epic for home health documentation (preferred). Excellent attention to detail, clear communication skills, and the ability to work autonomously are essential for success in this role.

Benefits of this role include:

* Hybrid Work Environment:
Enjoy a balance of remote and onsite work designed to support productivity, work-life balance, and collaboration. No weekends, holidays or on-call.

* Autonomous & Impactful Work:
Work independently to review and audit clinical documentation, ensuring compliance, accuracy, and high-quality patient care.

* Education & Mentorship Opportunities:
Help clinicians strengthen their documentation skills and understanding of OASIS/Epic. Serve as a resource and coach across the agency.

* Grow Your Expertise:
We'll support you in becoming OASIS-certified within one year of employment
-a valuable credential in home health leadership and quality roles. (supported by the organization).

Join our team and make a meaningful impact on patient care-without sacrificing the flexibility and autonomy that matter to you--and become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:

The RN Quality Assurance Specialist will oversee the clinical documentation of the direct care clinical staffto ensure it is compliant with Medicare, Medicaid/state/federal regulations, and agency policies and guidelines;works closely with Performance Improvement (PI) coordinator and agency educator to identify areas of education as needed; provides guidance and education to field staff regarding accurate, thorough documentation; and ensures timely submission and approval of the patient's plan of care and provider orders to ensure compliance with state and federal regulations.

Responsibilities:
1. Demonstrates working knowledge of regulatory and provider guideline, updating knowledge base continuously through self-study and in service attendance. Maintains awareness of current payor provider agreements in order to complete 485 and OASIS appropriately.
2. Assesses and interprets patient data as needed to provide guidance to Case Managers on patient needs relative to his/her age and conditions. Consults with patient case managers/team leaders for care coordination as necessary.
3. Promote and maintains interpersonal communication with all team members, clinicians and physicians.
4. Demonstrates ability to educate, develop and stimulate the professional growth and development of staff members. Serves as clinical resource to home health staff as well as physicians and their office staff as related to home care services, orders and diagnoses.
5. Identifies staff educational needs to ensure safe and effective patient clinical management. Recommends, plans and or participates in staff development programs for employees.
6. Ensures that all patient OASIS assessments are submitted by staff and that they are complete and compliant with Medicare/Medicaid/state/federal regulations and agency policy.
7. Responsible for reviewing for patient assessments for completeness, locking and submitting the assessment per regulatory guidelines. This includes, but not limited to: coding and diagnoses, patient short- and long-term goals with end points for all services, orders/goals for all disciplines, and notifies the clinical staff assessment revisions as needed.
8. Manages the implementation of nursing process to ensure quality of patient care delivery and monitors outcomes of care as appropriate.
9. Participates in employee educational programs to improve the quality of the patient plan of care and OASIS assessments.
10. Meets or exceeds daily assessment review…