Quality Assurance Nurse

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.