Clinical & Quality Operations Regulatory Coordinator

Home Healthcare, Hospice & Community Services • Keene, NH

7d

About The Position

The Clinical & Quality Operations Regulatory Coordinator supports regulatory compliance, survey readiness, quality assurance, and performance improvement activities across home health, hospice, and community-based services. This role ensures compliance with CMS Conditions of Participation, NH state regulations, and accreditation standards while supporting chart audits, appeals management, policy development, and corrective action initiatives.

Requirements

• Minimum 5-7 years in home health, hospice, or community-based care
• Demonstrated experience with State or CMS survey process
• Demonstrated experience with Formal fiscal auditing/response (CERT, TPE, OIG)
• Demonstrated experience with Clinical documentation review/auditing
• Strong knowledge of CMS Conditions of Participation (Home Health & Hospice)
• Strong knowledge of New Hampshire licensing requirements
• Experience in Chart audits and quality review
• Experience in Policy writing and compliance
• Experience in Denials and appeals management
• Analytical and detail-oriented
• Strong documentation and audit skills
• Ability to interpret and apply regulations
• Excellent communication and staff education skills
• Ability to manage multiple priorities and deadlines
• High level of discretion and professionalism

Responsibilities

• Coordinate survey readiness activities for CMS, NH DHHS, specialty programs, and accrediting organizations
• Conduct clinical record audits to ensure documentation quality, compliance, and plan-of-care adherence
• Manage ADRs, claim denials, and appeals, including tracking outcomes and identifying root causes
• Develop, review, and maintain clinical policies and procedures aligned with regulatory requirements and best practices
• Support QAPI initiatives through quality data analysis, reporting, and performance improvement projects
• Provide staff education related to documentation standards, regulatory updates, and survey readiness
• Collaborate with clinical, billing, compliance, and leadership teams to improve workflows, maintain compliance, and support quality outcomes
• This position serves as a key resource for regulatory interpretation, clinical quality improvement, and operational best practices across the organization.

What This Job Offers

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