Quality Assurance Registered Nurse, Home Health

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

📋 Description

• Proactively evaluate all OASIS assessments to confirm their accuracy, completeness, and adherence to federal and state home health regulations.

• Examine OASIS variation and alert reports to detect documentation discrepancies and emerging trends.

• Ensure accurate ICD‑10 coding and sequencing, encompassing primary diagnoses and co-morbidities.

• Work in conjunction with home health clinicians to resolve documentation concerns and facilitate necessary corrections.

• Review visit utilization to guarantee that services are in line with patient conditions, care guidelines, and reimbursement standards.

• Identify potential issues related to underutilization, overutilization, or financial risks and communicate findings to the Clinical Supervisor or their delegate.

• Report concerning trends in OASIS data, outcomes, and processes to leadership.

• Engage in Quality Improvement (QI), performance enhancement, and Corporate Compliance initiatives.

• Assist with additional chart audits and clinical documentation assessments as required.

⛳️ Requirements

• Must be a Registered Nurse (RN) holding an active California license.

• A minimum of 2 years of home health nursing experience is essential.

• Strong proficiency in OASIS is required (OASIS-E preferred).

• Thorough understanding of CMS regulations, Medicare Conditions of Participation (CoPs), and state licensure requirements.

• Excellent analytical abilities with a keen attention to detail and sound clinical judgment.

• Strong communication and teamwork skills for effective collaboration with interdisciplinary teams.

🏝️ Benefits

• Health insurance.

• Flexible work arrangements.

• Opportunities for professional development.