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Quality Assurance Nurse
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Comforting Care Hospice
Simi Valley, CA (In Person)
$91,513 Salary, Full-Time
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Job Description
Quality Assurance Nurse Comforting Care Hospice Simi Valley, CA Job Details Full-time $34.34 - $45.00 an hour 1 day ago Benefits Free parking Health insurance 401(k) Paid time off Qualifications Anatomy knowledge RN License Clinical documentation Quality audits Medical terminology Full Job Description Job Summary We are seeking a dedicated and detail-oriented Quality Assurance Nurse to uphold the highest standards of patient care and clinical documentation within our Home Health organization. The ideal candidate will possess comprehensive clinical knowledge, strong familiarity with home health regulations, and expertise in documentation review and quality improvement. As a Quality Assurance Nurse, you will play a vital role in ensuring compliance with Medicare Conditions of Participation (CoPs), CMS regulations, and agency policies while supporting quality initiatives that enhance patient outcomes and regulatory compliance. Responsibilities Conduct thorough reviews of home health clinical records to ensure accuracy, completeness, and compliance with Medicare Conditions of Participation (CoPs), CMS regulations, HIPAA, and agency documentation standards. Collaborate with clinicians, including Registered Nurses, Physical Therapists, Occupational Therapists, Speech Therapists, and Medical Social Workers, to improve documentation practices and support Clinical Documentation Improvement (CDI) initiatives. Review OASIS assessments (SOC, ROC, Recertification, Transfer, Resumption of Care, Discharge) for accuracy, consistency, and timely submission. Perform quality assurance audits to ensure compliance with physician orders, Plans of Care (CMS-485), visit documentation, medication reconciliation, and care coordination requirements. Monitor compliance with Medicare, Medicaid, and commercial payer guidelines for home health services. Utilize Electronic Medical Record (EMR/EHR) systems such as Homecare Homebase (HCHB), WellSky (Kinnser), MatrixCare, Axxess, or other home health software to review documentation and maintain quality records. Support case management, care coordination, discharge planning, and interdisciplinary communication to promote quality patient care in the home setting. Track quality indicators, adverse events, infection prevention measures, hospitalization rates, and performance improvement metrics. Stay informed of evolving CMS regulations, Conditions of Participation, Value-Based Purchasing (HHVBP), OASIS guidance, and accreditation standards. Assist in educating clinical staff on documentation requirements, home health regulations, medical terminology, and quality improvement best practices. Experience Proven experience in a Home Health agency with a focus on clinical documentation review, quality assurance, utilization review, or clinical compliance. Strong knowledge of Medicare Home Health Conditions of Participation (CoPs), CMS regulations, OASIS documentation, and home health reimbursement requirements. Experience reviewing Plans of Care, physician orders, visit documentation, medication profiles, and interdisciplinary documentation. Experience using Home Health EMR/EHR systems such as Homecare Homebase (HCHB), WellSky (Kinnser), MatrixCare, Axxess, or similar documentation platforms. Knowledge of Medicare and Medicaid home health regulations, quality reporting programs, and Value-Based Purchasing initiatives. Previous experience with Quality Assurance and Performance Improvement (QAPI), chart audits, and regulatory survey preparedness preferred. Excellent understanding of medical terminology, anatomy, physiology, infection prevention, HIPAA compliance, and clinical documentation standards. Current Registered Nurse (RN) license preferred with home health clinical experience. Join our team as a Quality Assurance Nurse and help ensure the delivery of exceptional home health services through meticulous documentation review, regulatory compliance, and continuous quality improvement—contributing directly to better patient outcomes and excellence in home-based care.