Customer Insights Manager, Home Health/Hospice

This is a fully remote position, open to applicants in United States.

📋 Description

• Convert CMS Conditions of Participation, state regulations, accreditation standards, and payer requirements into operational workflows and AI rule sets.

• Maintain compliance rule libraries that encompass OASIS-E accuracy, HOPE assessment validation, hospice eligibility/recertification documentation, PDGM coding compliance, and SDoH capture.

• Provide clinical validation and subject matter expertise for AI-driven compliance prompts, Live Quality Assist nudges, and compliance dashboard checks.

• Review AI-generated narrative notes, OASIS responses, and HOPE items for clinical accuracy and regulatory conformity.

• Facilitate discovery sessions with HH&H executives, QA/QAPI directors, and clinicians to pinpoint compliance needs and workflow deficiencies.

• Support end-to-end compliance implementations, including data schema validation, EHR ingestion review, and custom rule development.

• Act as the HH&H compliance Subject Matter Expert (SME) during customer meetings, Quarterly Business Reviews (QBRs), and onsite visits alongside sales, customer success, and implementation teams.

• Educate internal teams on HH&H compliance personas, regulatory frameworks, and market dynamics.

• Collaborate with Product, Clinical Strategy, Engineering, and Sales Engineering to ensure HH&H needs are reflected in product and go-to-market materials.

• Monitor alterations in CMS regulations, MAC and payer requirements, and accreditation standards, translating market and competitive signals into product and positioning recommendations.

⛳️ Requirements

• Clinical licensure and direct patient care experience in home health or hospice (RN, PT, OT, SLP, SW, or equivalent).

• Over 5 years of experience in quality assurance, compliance, or clinical operations leadership within a home health, hospice, or integrated HH&H organization.

• Extensive working knowledge of CMS Conditions of Participation, OASIS-E, HOPE, PDGM, and standards for hospice eligibility/recertification documentation.

• Practical experience with audit preparation, including CMS surveys, state surveys, ADRs, ZPIC/UPIC audits, QAPI programs, and corrective action planning.

• Familiarity with prominent HH&H EHR systems, such as HCHB/Homecare Homebase, WellSky/Kinnser, MatrixCare, Netsmart, Careficient, and Healthwyse.

• Strong project management skills with the ability to prioritize and execute across multiple workstreams concurrently.

• Experience with LLM prompt engineering, AI model validation, or data-driven quality improvement methodologies.

• COS-C, CHC, CPHQ, or HCS-D certifications are considered beneficial.

• A background in revenue cycle management, coding compliance, or billing operations in HH&H is a plus.

• Experience in navigating PDGM recoupment risk, hospice fraud enforcement, or CMS TPE reviews is advantageous.

🏝️ Benefits

• A team of exceptional individuals who share a vision and have an unwavering drive to achieve it.

• An opportunity to build, grow, and play a significant role in shaping how technology can enhance the effectiveness of therapy.

• Fully remote work environment.

• Competitive health and well-being benefits, mental healthcare support, and life and AD&D insurance.

• Significant equity and 401(k) plans matched at 4%.

• Company-sponsored retirement plan.

• Global business travel insurance for you and any dependents traveling with you.

• Domestic conference budget and annual learning & development stipend.

• Remote work stipend.

• Generous PTO, additional mental health days, and paid time off to recharge, care for yourself and loved ones, and manage life's moments.

• Coverage for fertility treatment and family planning.

• Annual learning & development stipend.

• Employee resource groups and team-driven celebrations and events.