Healthcare Quality Assurance Manager

About the Role

Our client is a US-based home healthcare provider offering skilled home-based care from physical therapy and rehabilitation to disease management and diet consulting giving patients the continued support that allows them to recover exactly where they want to be: at home. Being surrounded by loved ones while undergoing care and treatment in familiar surroundings improves quality of life and often shortens recovery time while lowering the overall cost of care.

They are now looking for a Healthcare Quality Assurance Manager to join their clinical team.

The Role

This is a nurse-led quality assurance position responsible for reviewing clinical documentation for accuracy completeness and compliance and for working closely with clinical and administrative teams to maintain high standards of patient care. The role reports to the Director Clinical Services and requires strong independent judgment to plan prioritize and manage a varied workload in a fast-paced environment.

Key Responsibilities

• Review nurses notes for accuracy and completeness prior to submission returning any incomplete or incorrect records for correction
• Review physician orders medication profiles and aide care plans against nurses documentation
• Review Medicaid and other payer clinical records to ensure documentation supports appropriate reimbursement quality of care and adherence to the care plan
• Coordinate communication between team members physicians and caregivers to ensure appropriate well-documented care
• Support performance improvement activities and stay current through ongoing clinical training
• Identify clinical documentation trends and deficiencies and guide staff on corrective action
• Participate in bi-weekly QA/Clinical meetings
• Prepare weekly QA reports including volumes reviewed and outstanding issues

Requirements

• Bachelors degree and current Registered Nurse license in good standing
• Minimum of 3 years professional nursing or clinical QA experience
• Strong written and verbal communication skills
• Excellent organizational skills with the ability to work both independently and as part of a team
• Sound judgment attention to detail and a proactive approach to problem-solving