Key Responsibilities
Conduct comprehensive clinical record reviews to verify documentation accuracy, quality of care, visit utilization, and adherence to care plans, agency policies, and regulatory requirements.
Perform chart audits and quality assurance reviews to ensure compliance with home healthcare regulations, CMS guidelines, accreditation standards, and documentation requirements.
Monitor quality indicators, identify trends, and recommend corrective actions to improve clinical documentation and service delivery.
Develop and implement action plans to address identified compliance gaps and documentation inconsistencies.
Collaborate with Clinical Managers and Administrators by providing regular quality assurance reports and recommendations for process improvements and staff development.
Participate in quality improvement initiatives, staff orientation, and in-service training programs.
Ensure clinical documentation supports accurate reimbursement and meets organizational quality standards.
Maintain compliance with agency quality assurance targets and support continuous monitoring of performance metrics.
Promote effective communication and collaboration across multidisciplinary care teams.
Perform other quality assurance and compliance-related duties as assigned.
Qualifications & Requirements
Registered Nurse (RN) with a current and valid nursing license (preferred).
Minimum of 2 years' experience in Nursing or home healthcare, including at least 1 year in a Quality Assurance (QA) role.
Experience in a home health agency and strong knowledge of home healthcare regulations is an added advantage.
Strong knowledge of CMS guidelines, accreditation standards, and clinical documentation requirements.
Experience conducting chart audits, compliance reviews, and quality improvement initiatives.
Familiarity with OASIS, Electronic Medical Records (EMR), and home health billing documentation is highly desirable.
Excellent analytical, organizational, communication, and problem-solving skills, with the ability to work independently and collaboratively.
Must be proficient in written and spoken English.
Must successfully pass a criminal background check.