Home Care Quality Specialist

POSITION SUMMARY

The Home Care Quality Specialist is responsible for coordinating and conducting quality assurance, quality improvement and regulatory compliance activities for home care operations. Serving as an organizational subject matter expert (SME), they provide guidance and consultation on documentation requirements, regulatory expectations, and accreditation standards to support compliance with state, federal, and accreditation and company standards. Works collaboratively with the Performance Excellence department and Home Care leadership team. The Home Care Quality Specialist supports home care compliance and continuous quality improvement initiatives. 

• Conducts Home Care quality assurance, improvement and regulatory compliance activities in collaboration with Home Care leaders. 
• Audits and analyzes patient records and data to ensure quality patient care, appropriateness of services, and identifies opportunities for improvement. 
• Gathers and compiles data on high-risk, high-volume, and/or problem-prone areas. Identifies trends, makes recommendations and completes follow-up audits to ensure compliance. 
• Supports staff and leadership to ensure complete and accurate quality reporting (OASIS & HOPE) documentation prior to OASIS & HOPE survey submission.
• Understands Epic/Home Care (home health and hospice) documentation workflows. 
• Routinely reviews regulatory requirements and shares updates with Home Care leadership.
• Successfully completes initial and ongoing organizational and department education, training, and competency requirements.
• Infection Control: Understands, demonstrates, and follows organizational infection control guidelines (CDIC).
• Quality: Focuses on improving processes and champions efficiency in daily work activities.
• Safety: Promotes a culture of safety by taking accountability for individual actions, including but not limited to, promptly reporting errors or near misses via the organization’s occurrence reporting system and participating in developing improved safety processes, as appropriate. (ADM023 and Mission Statement).
• Performs other duties as assigned.

JOB REQUIREMENTS 

Licenses:

• State of Wisconsin Professional licensure for Physical Therapy or Registered Nurse required.

Education:

• Nursing: Bachelor’s degree in Nursing required.

OR

• Physical Therapy:
• Master’s degree in: Physical Therapy preferred.
• Doctor of Physical Therapy preferred.
• Other: OASIS COS-C.

Experience:

• Minimum of 2 years of clinical experience in nursing or physical therapy required, 
• Experience with home care (home health and hospice) regulations strongly preferred. 
• Experience with Microsoft office required.
• Knowledge in home health billing, Centers for Medicare Services (CMS) payment system and relationships o home health coding and reimbursement required. 
• Preferred certification in quality science (ex: CPHQ, CSSGB, etc....)
• Experience in Epic documentation is preferred. 

Miscellaneous:

• CPR/BLS Certification is required.