Quality Management RN

AmeriCare•New York, NY

3d•Onsite

About The Position

The Quality Management Nurse is a Registered Professional Nurse who will ensure regulatory compliance and continuous performance improvement. Responsibilities include appeals preparation, grievance tracking, patient satisfaction analysis, and competency evaluations. The ideal candidate demonstrates professionalism, attention to detail, and a commitment to excellence in patient care and staff support.

Requirements

NYS RN License
Strong knowledge of CHHA regulations, including federal, state, and Department of Health (DOH) requirements.
Demonstrated understanding of Medicare Conditions of Participation (CoPs) for home health, including compliance with documentation, visit frequency, and billing requirements.
Experience conducting clinical record reviews to ensure accuracy, completeness, and compliance with regulatory standards.
Familiarity with Outcome and Assessment Information Set (OASIS) data collection and its impact on quality reporting and reimbursement.
Proven ability to analyze quality metrics, identify trends, and implement corrective action plans.
Prior involvement in survey readiness, audits, or responses to regulatory bodies (e.g., OMIG, CMS, DOH).
Strong communication skills with the ability to collaborate across clinical, administrative, and operational teams to improve patient outcomes and compliance.
Proficiency in using Electronic Medical Records (EMR) systems, such as HCHB or similar platforms.