Become a part of our caring community and help us put health first

Reports To: Associate Director Home Health Branch Administrator
FLSA: Exempt

Work Schedule: Full-time/40 Hours

Position Type: On-site

Branch Location: Raleigh NC

This is not a remote or work-from-home position. This position requires you to sit on-site at our Raleigh NC branch location.

TheRN QA Clinical Managerwill play a critical role in ensuring clinical documentation and services comply with all applicable regulations standards and best practices. This role reviews patient records audits clinical documentation OASIS assessments and provides feedback to staff. This role supports quality improvement initiatives to ensure the highest standards of patient care and regulatory compliance.

• Reviews and audits clinical documentation (OASIS visit notes plan of care) for accuracy completeness and compliance with Medicare/CMS accreditation standards.

• Collaborates with field-based clinicians to ensure timely submission of documentation and to resolve deficiencies or inconsistencies.

• Assists with OASIS accuracy and validation; ensures data entry aligns with care plans and physician orders.

• Monitors outcome-based quality indicators and assists in developing performance improvement plans.

• Participates in quality improvement projects internal audits and regulatory survey readiness.

• Tracks and reports quality metrics trends and areas for improvement to leadership.

• Provides staff education and support on compliance issues and documentation standards.

• Stays current on federal and state regulations related to home health care and quality assurance.

Use your skills to make an impact

Education:

• Associate degree in Nursing (ADN) required; Bachelor of Science in Nursing (BSN) strongly preferred.

License/Certifications:

• Active and unrestricted Registered Nurse (RN) license or Compact State RN license with authorization to practice in the state of North Carolina.

• Proof of current CPR card and/or BLS certification.

Required Experience/Skills:

• Valid drivers license auto insurance and reliable transportation.

• Experience in quality assurance clinical auditing and compliance required.

• Home health experience is required.

• Management and people leadership experience is required.

• Knowledge of Medicare Conditions of Participation (COP) for home health is required.

• OASIS experience is required. OASIS certification (HCS-O COQS and/or COS-C) preferred.

• Must have experience with the following OASIS assessment types: starts of cares (SOC) resumption of cares (ROC) re-certifications discharges from care (DC) and transfer of cares.

• Homecare Homebase (HCHB) experience preferred.

• CMS PDGM experience is required.

• Value-based purchasing experience is required.

• Detail-oriented with excellent analytical and problem-solving skills.

• Excellent communication facilitation and interpersonal skills.

Additional Information

• Normal Hours of Operation: M-F / 8a-5p (ET)

• On-Call Expectation: Yes rotating on-call shift

• Branch Size: 500 Census (4.0 STAR rating)

• Annual Bonus Eligible: Yes eligible for the annual incentive bonus which has pay-outs both quarterly and annually.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills knowledge experience education certifications etc.

$77200 - $106200 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana Inc. and its affiliated subsidiaries (collectively Humana) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits Humana provides medical dental and vision benefits 401(k) retirement savings plan time off (including paid time off company and personal holidays volunteer time off paid parental and caregiver leave) short-term and long-term disability life insurance and many other opportunities.

About Us

About CenterWell Home Health: CenterWell Home Health specializes in personalized comprehensive home care for patients managing a chronic condition or recovering from injury illness surgery or hospitalization. Our care teams include nurses physical therapists occupational therapists speech-language pathologists home health aides and medical social workers all working together to help patients rehabilitate recover and regain their independence so they can live healthier and happier lives.

About CenterWell a Humana company: CenterWell creates experiences that put patients at the center. As the nations largest provider of senior-focused primary care one of the largest providers of home health services and fourth largest pharmacy benefit manager CenterWell is focused on whole-person health by addressing the physical emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM) CenterWell offers stability industry-leading benefits and opportunities to grow yourself and your career. We proudly employ more than 30000 clinicians who are committed to putting health first for our teammates patients communities and company. By providing flexible scheduling options clinical certifications leadership development programs and career coaching we allow employees to invest in their personal and professional well-being all from day one.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race color religion sex sexual orientation gender identity national origin age marital status genetic information disability or protected veteran status. It is also the policy of Humana to take affirmative action in compliance with Section 503 of the Rehabilitation Act and VEVRAA to employ and to advance in employment individuals with disability or protected veteran status and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions including but not limited to recruitment hiring upgrading promotion transfer demotion layoff recall termination rates of pay or other forms of compensation and selection for training including apprenticeship at all levels of employment.