Clinical Quality Assurance Specialist

Humana • Work at Home - Florida, FL

1d • $71,100 - $97,800 • Remote

About The Position

The Clinical Quality Assurance Specialist partners closely with clinical teams and branch leadership to drive excellence in patient care, regulatory compliance, and performance improvement. You will serve as a subject matter expert, providing guidance, education, and data-driven insights to ensure high-quality clinical outcomes and adherence to industry standards. Assignments are varied and require independent judgment, critical thinking, and proactive decision-making. You will report to Quality Assurance Director.

Requirements

• Current state license as a Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist.
• Home health experience
• Proficiency in OASIS, CMS regulations, and clinical documentation standards.
• 2+ years of training and learning development experience
• Understanding of curriculum design and adult learning principles
• Experience using several training tools to facilitate to a wide audience.

Nice To Haves

• COS-C certification
• Experienced with Wellsky/Kinnser or comparable healthcare EMR platforms
• Bilingual (English and Spanish speaker)

Responsibilities

• Collaborate with branch leadership to develop and implement quality assurance and performance improvement strategies
• Provide education and coaching to field clinicians and case managers, including instructor-led sessions
• Support branches in regulatory compliance, survey readiness, and quality improvement plans
• Help with new hire onboarding and training focused on clinical documentation, OASIS, and regulatory requirements
• Conduct chart audits and data analysis, delivering applicable feedback to improve clinical quality and compliance
• Monitor and support quality investigations and compliance processes
• Partner with leadership to identify trends, gaps, and opportunities for improvement
• Contribute to special projects and organizational plans as assigned

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed