Clinical Quality Manager

Adaptive Home Health•Houston, TX

6d•Remote

About The Position

We are fixing US healthcare by building an AI-native physical care platform, starting with home health. Our centralized team of Clinical Quality Managers assume responsibility for many HCHB and back-office clinical functions. This centralized role is purpose-built to focus on accuracy, timeliness, regulatory compliance, and efficient process. This critical role relieves a portion of the administrative burden for branch teams, allowing Branch Clinical Managers to fully focus on active management of patient care and clinician skill development. The Clinical Quality Manager is a centralized, remote RN role that provides clinical backbone support to the field clinical team. This is not a field position — the Clinical Quality Manager operates from a central hub to ensure that orders, EMR workflows, back-office clinical functions, and regulatory and billing compliance tasks are completed with accuracy and timeliness. The Clinical Quality Manager brings the knowledge and expertise of a registered nurse to back-office functions that require clinical oversight — processing and approving orders, monitoring patient status flags in EMR/dashboards, and supporting quality and compliance tracking. This role is purpose-built to take high-volume, process-intensive clinical tasks off the branch Clinical Manager's plate so that the branch Clinical Manager can focus on direct clinical oversight, coaching, and rehospitalization prevention in the field. This is NOT a passive support role. The Clinical Quality Manager is accountable for timely, accurate clinical decision-making within the EMR. You will own workflows that directly affect patient safety, billing integrity, and regulatory compliance.

Requirements

Active RN license (required) — clinical judgment is core to this role
Strong EMR proficiency with HCHB
Exceptional attention to detail and commitment to documentation accuracy
Ability to manage high-volume, time-sensitive workflows without losing quality
Understanding of home health regulatory requirements
Ability to work independently and manage time effectively in a remote environment
Clear written and verbal communication; ability to escalate clinical concerns appropriately

Responsibilities

Drive quality, safety, and compliance through systems
Identify recurring clinical and documentation issues and implement process improvements
Support quality assurance activities by ensuring clinical work meets standards before downstream review
Order management & EMR workflow execution
Review and approve new orders in EMR; ensuring: compliance with documentation standards for verbal orders, orders are complete and address patient care needs
Complete clinical escalation reviews at intake to support referral processing
End of episode management
Review daily discharge reports; verify DC summaries and signed orders are complete and accurate
Confirm NOMNC is on file for all appropriate discharges
Process discipline-only and full discharge orders as they arise
Hospital Hold Process Management
Manage hospital hold information, inpatient transfer processes, and POC completion for hospitalized patients
Discharge clients in facility at end of episode as needed
Manage resumption of care workflows, ensure timely resumption of care, oversee pending delay approvals in the EMR
Quality & Compliance Monitoring
Review and track infection control reports
Monitor for wound score deviations and escalate appropriately
Review and trend QI events weekly; identify patterns and flag for clinical leadership
Review and process clinical alerts and potentially avoidable event notifications
Audit missed visits by clinician and unverified missed visits daily to support appropriate care delivery as well as LUPA risk management; confirm proper documentation and follow-up
Patient Status Monitoring
Monitor vital sign parameter alerts for active patients, ensuring appropriate documentation, notifications, and follow-up; escalating to branch Clinical Manager as appropriate
Review coordination notes for physician updates, medication interactions, and clinically significant medication issues
Review dashboards for change-in-condition with appropriate clinical judgment and escalation