Quality Assurance Specialist (RN)

Elite Home Health•Sarasota, FL

About The Position

The RN Quality Assurance Specialist supports clinical quality, regulatory compliance, documentation accuracy, and survey readiness across Elite Home Health. Using professional nursing judgment and home health expertise, the role reviews clinical documentation, OASIS assessments, plans of care, orders, and other patient records for accuracy, clinical appropriateness, and compliance with Medicare Conditions of Participation, applicable state and federal regulations, accreditation standards, and agency policies. The position works with clinical leadership, field clinicians, and interdisciplinary teams to identify improvement opportunities, provide education and feedback, support QAPI initiatives, and promote high-quality patient care and positive outcomes in the home health setting. The role also supports readiness for ACHC surveys, Medicare audits, regulatory inspections, and other compliance reviews. Elite Home Health is a clinician-owned and operated organization serving Florida communities for over a decade. It describes its culture as patient-centered, supportive, mission-driven, and focused on teamwork, professional growth, and continuous improvement.

Requirements

Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) from an accredited nursing program.
Current, unrestricted Registered Nurse (RN) license in the State of Florida.
At least two years of clinical experience in Medicare-certified home health.
Home health OASIS experience.
Strong knowledge of Medicare Conditions of Participation, OASIS requirements, home health documentation standards, and applicable regulatory requirements.
Strong clinical judgment, critical thinking, analytical, and problem-solving skills.
Exceptional attention to detail and ability to identify clinical documentation and compliance discrepancies.
Strong organizational and time-management skills, including the ability to manage multiple priorities.
Effective written and verbal communication skills and ability to provide constructive education and feedback to clinical staff.
Strong communication, collaboration, and teamwork skills.
Ability to work effectively in a fast-paced, patient-centered home health environment.
Ability to successfully complete required background screening and other employment and regulatory requirements.

Nice To Haves

Previous experience in quality assurance, clinical auditing, utilization review, QAPI, compliance, or a similar home health quality role.
Experience with home health EMR systems such as Axxess, WellSky/Kinnser, or similar systems.

Responsibilities

Review clinical records for completeness, accuracy, consistency, timeliness, clinical appropriateness, and regulatory compliance.
Review OASIS assessments for accuracy and consistency with the patient’s clinical condition, supporting documentation, and plan of care.
Review plans of care, orders, assessments, visit documentation, and other clinical records to identify documentation gaps, discrepancies, or compliance concerns.
Evaluate documentation to ensure it supports skilled need, medical necessity, services provided, and the patient’s ongoing home health plan of care, as applicable.
Monitor compliance with Medicare Conditions of Participation, OASIS requirements, applicable federal and Florida regulations, accreditation standards, and agency policies.
Support readiness for ACHC surveys, Medicare audits, regulatory inspections, and other compliance reviews.
Identify clinical documentation and compliance deficiencies, and collaborate with clinical leadership and staff on follow-up and resolution.
Provide clinicians with education, coaching, and feedback on OASIS, documentation standards, regulatory requirements, and improvement opportunities.
Support the agency’s QAPI program by monitoring quality indicators, clinical outcomes, compliance metrics, and performance trends.
Assist with developing, implementing, and monitoring corrective action plans and performance improvement initiatives.
Review assigned trends in hospitalizations, rehospitalizations, adverse events, complaints, infection control, patient outcomes, and other quality measures.
Prepare quality assurance reports, audit summaries, trend reports, and compliance updates for leadership review.
Participate in QAPI meetings, quality reviews, staff meetings, and required in-services.
Collaborate with clinical, intake, scheduling, billing, and operational teams to support quality patient care and regulatory compliance.
Escalate significant clinical, patient safety, regulatory, or compliance concerns to appropriate leadership.
Maintain organized and accurate records related to audits, compliance reviews, corrective actions, and quality improvement activities.
Protect the confidentiality of patient, employee, and agency information in accordance with HIPAA and agency policies.
Promote patient safety, accountability, regulatory compliance, and continuous improvement.