QA-Home Health RN

Job Description

Home Health RN Quality Assurance (QA) opening

• Fulltime M-F, Day shift
• In-Office. Office located in Oakland County
• Must have RN and Home Health QA experience
• Must want to make a difference and be proactive

Home Health Quality Assurance (QA) RN ensures clinical documentation and patient care practices comply with regulatory standards, such as those set by Medicare (CMS) and state health departments, while optimizing patient outcomes.

• Documentation Audits: Perform comprehensive chart reviews of OASIS (Outcome and Assessment Information Set) and 485 Plans of Care to verify accuracy, clinical necessity, and adherence to protocols.
• Compliance Oversight: Ensure the agency follows HIPAA regulations and other accreditation standards while preparing for external audits.
• Quality Improvement: Collaborate on QAPI (Quality Assessment and Performance Improvement) initiatives to address clinical deficiencies and improve service delivery.
• Staff
  
  Education:
  
  Orient and train nursing staff on documentation standards, ICD-10 coding, and evidence-based best practices.
• Incident Management: Review adverse events, medication errors, and patient complaints to conduct root cause analyses and implement corrective actions.

• Education: Valid Registered Nurse (RN) license; a Bachelor of Science in Nursing (BSN) is often preferred.
• Experience: Generally 3–5 years of recent home health experience, with specific exposure to quality assurance or clinical auditing.
• Technical
  
  Skills:
  
  Proficiency in Home Health Electronic Medical Record (EMR) systems (e.g., Well Sky, Homecare Homebase) and data analytics tools.
• Certifications (Preferred):
• COS-C (Certificate for OASIS Specialist-Clinical).
• HCS-D (Home Care Coding Specialist-Diagnosis).
• CPHQ (Certified Professional in Healthcare Quality).

• Billing Accuracy: Timely final sign-off on Plans of Care to prevent billing delays.
• Audit Readiness: Maintaining consistently high compliance scores for internal and external regulatory surveys.
• Patient Outcomes: Tracking improvement in standardized patient health metrics as reported via OASIS.