Quality Assurance Specialist
About The Position
The Home Care Quality Assurance (QA) Specialist is responsible for monitoring, evaluating, and improving the quality of care delivered by the home health agency. This role ensures compliance with CMS Conditions of Participation, State regulations, Star Ratings, Value-Based Purchasing (VBP), and internal quality standards. The QA Specialist collaborates with clinical leadership to analyze data, identify performance gaps, provide staff education and drive continuous quality improvement initiatives. This job description reflects management’s assignment of essential functions; and nothing in this herein restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
Requirements
- Licensed clinician (RN preferred; PT, OT, or other licensed home health clinician considered)
- Minimum of 2–3 years of home health experience
- Strong knowledge of OASIS, CMS regulations, and home health quality measures
- Experience with clinical documentation review and audits
- Strong analytical, organizational, and communication skills
- Computer literacy and experience with Microsoft Office
- Must have current, valid driver’s license and reliable transportation.
- Attention to detail
- Data-driven decision-making
- Continuous improvement mindset
Nice To Haves
- Quality, compliance, or QAPI experience in home health
- Familiarity with EMR systems (HCHB) and quality reporting tools (SHP)
- Certification in healthcare quality or compliance (e.g., HCS-D, COS-C, or similar)
Responsibilities
- Conduct routine and targeted audits of clinical records for utilization review to ensure accuracy, completeness, and regulatory compliance
- Review OASIS documentation for clinical accuracy and impact on Star Ratings and VBP measures
- Ensure compliance with CMS, state, and accrediting body requirements
- Identify trends, deficiencies, and opportunities for improvement
- Assist with processing of workflow as requested
- Perform audits and identify trends related to hospitalizations
- Provide feedback and education to clinicians (1:1 or group settings) regarding documentation best practices and quality standards
- Assist with development and delivery of quality-focused education and training programs
- Serve as a resource for staff related to quality measures, compliance, and performance outcomes
- Remain up to date on industry changes and maintain certifications
- Work closely with clinical leadership, clinical education, operations, and intake staff to improve patient outcomes and ensure clinical documentation is up to date with best practice standards and regulatory requirements
- Communicate quality findings clearly and professionally to interdisciplinary teams
- Participate in quality meetings and performance review discussions
- Other duties as assigned.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
501-1,000 employees
