Overview Join our dynamic healthcare team as a Home Health Quality Assurance Specialist, where your expertise will drive excellence in patient care and ensure compliance with all regulatory standards. In this vital role, you will oversee quality assurance processes within home health services, monitor adherence to healthcare regulations, and lead initiatives to improve service quality. Your proactive approach will help maintain the highest standards of patient safety, regulatory compliance, and operational efficiency, empowering our organization to deliver exceptional home health care experiences. Responsibilities Develop, implement, and monitor quality assurance programs aligned with healthcare regulations such as CMS (Centers for Medicare and Medicaid Services), JCAHO (Joint Commission), and FDA regulations. Conduct comprehensive audits of electronic health records (EHR) and electronic medical records (EMR) to ensure accuracy, completeness, and compliance with HIPAA and other privacy laws. Review clinical documentation for CPT coding, ICD-9, ICD-10, and ICD coding accuracy to support proper billing and reimbursement processes. Collaborate with interdisciplinary teams to identify areas for process improvement and implement best practices in healthcare compliance management. Analyze data trends related to patient outcomes, risk management, and quality metrics to inform strategic decisions and enhance service delivery. Lead training sessions on healthcare compliance standards, medical terminology, Medicare policies, and CMS regulatory requirements for staff members. Manage accreditation readiness activities by ensuring adherence to JCAHO standards and other regulatory requirements through ongoing assessments and documentation. Requirements Proven experience in healthcare quality assurance within a home health or similar healthcare setting. Strong knowledge of HIPAA regulations, CMS guidelines, Medicare policies, JCAHO accreditation standards, and FDA regulations. Proficiency in CPT coding, ICD-9/ICD-10 coding systems, medical terminology, and healthcare compliance management tools. Technical skills in Microsoft Office Suite (Word, Excel, PowerPoint) as well as EMR/EHR systems for data analysis and documentation management. Demonstrated project management experience with a focus on process improvement initiatives in healthcare environments. Excellent analytical skills with the ability to interpret complex data sets related to quality metrics and clinical outcomes. Effective team leadership capabilities with experience in training staff on healthcare policies and compliance procedures. Strong understanding of healthcare law, risk management principles, managed care operations, and accreditation standards such as JCAHO. Join us in shaping the future of home health care by ensuring our services meet the highest standards of quality and compliance! Your dedication will make a meaningful difference in patients' lives while advancing your career in a fast-paced, supportive environment committed to excellence.

Work Location:

In person