Quality Assurance Specialist (RN) - Home Health

Job Title: RN Quality Assurance Specialist

Reports To: 

About Elite Home Health

Elite Home Health is a clinician-owned and operated organization serving communities across Florida for over a decade. We are committed to delivering high-quality, patient-centered care while creating a supportive environment where our team members can grow professionally and feel valued in their work.

We believe exceptional patient care begins with exceptional people. That's why we're committed to supporting, developing, and investing in our team so they can make a meaningful difference in the lives of the patients and communities we serve.

Position Summary

The RN Quality Assurance Specialist is responsible for supporting clinical quality, regulatory compliance, documentation accuracy, and survey readiness across the organization. Utilizing professional nursing judgment and home health expertise, this position reviews clinical documentation, OASIS assessments, plans of care, orders, and other patient records to ensure accuracy, clinical appropriateness, and compliance with Medicare Conditions of Participation (CoPs), applicable state and federal regulations, accreditation standards, and agency policies.

This position works closely with clinical leadership, field clinicians, and interdisciplinary teams to identify opportunities for improvement, provide education and feedback, support QAPI initiatives, and promote high-quality patient care and positive outcomes in the home health setting.

Key Responsibilities

• Review clinical records for completeness, accuracy, consistency, timeliness, clinical appropriateness, and regulatory compliance
• Review OASIS assessments for accuracy and consistency with the patient's clinical condition, supporting documentation, and plan of care
• Review plans of care, orders, assessments, visit documentation, and other clinical records to identify documentation gaps, discrepancies, or compliance concerns
• Evaluate documentation to ensure it supports skilled need, medical necessity, services provided, and the patient's ongoing home health plan of care, as applicable
• Monitor compliance with Medicare Conditions of Participation (CoPs), OASIS requirements, applicable federal and Florida regulations, accreditation standards, and agency policies
• Support ongoing readiness for ACHC surveys, Medicare audits, regulatory inspections, and other compliance reviews
• Identify clinical documentation and compliance deficiencies and collaborate with clinical leadership and staff to ensure appropriate follow-up and resolution
• Provide education, coaching, and feedback to clinicians regarding OASIS, documentation standards, regulatory requirements, and identified opportunities for improvement
• Support the agency's Quality Assessment and Performance Improvement (QAPI) program by monitoring quality indicators, clinical outcomes, compliance metrics, and performance trends
• Assist with the development, implementation, and monitoring of corrective action plans and performance improvement initiatives
• Review trends related to hospitalizations, rehospitalizations, adverse events, complaints, infection control, patient outcomes, and other quality measures as assigned
• Prepare quality assurance reports, audit summaries, trend reports, and compliance updates for leadership review
• Participate in QAPI meetings, quality reviews, staff meetings, and required in-services
• Collaborate with clinical, intake, scheduling, billing, and operational teams to support quality patient care and regulatory compliance
• Escalate significant clinical, patient safety, regulatory, or compliance concerns to appropriate leadership
• Maintain accurate and organized records related to audits, compliance reviews, corrective actions, and quality improvement activities
• Maintain confidentiality of patient, employee, and agency information in accordance with HIPAA and agency policies
• Promote a culture of patient safety, accountability, regulatory compliance, and continuous improvement

Qualifications

• Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) from an accredited nursing program required
• Current, unrestricted Registered Nurse (RN) license in the State of Florida required
• Minimum of two (2) years of clinical experience in Medicare-certified home health required
• Home health OASIS experience required
• Strong knowledge of Medicare Conditions of Participation (CoPs), OASIS requirements, home health documentation standards, and applicable regulatory requirements
• Previous experience in quality assurance, clinical auditing, utilization review, QAPI, compliance, or a similar home health quality role preferred
• Experience with home health EMR systems such as Axxess, WellSky/Kinnser, or similar systems preferred
• Strong clinical judgment, critical thinking, analytical, and problem-solving skills
• Exceptional attention to detail with the ability to identify clinical documentation and compliance discrepancies
• Strong organizational and time-management skills with the ability to manage multiple priorities
• Effective written and verbal communication skills with the ability to provide constructive education and feedback to clinical staff
• Strong communication, collaboration, and teamwork skills
• Ability to work effectively in a fast-paced, patient-centered home health environment
• Ability to successfully complete required background screening and other employment and regulatory requirements

Why Elite Home Health

We know great professionals have choices—here’s why they choose Elite Home Health:

• Competitive compensation and performance-based opportunities
• Supportive leadership that values your voice and expertise
• Strong clinical and operational support teams (you never feel alone in your role)
• Career growth and advancement opportunities within a growing organization
• A mission-driven culture centered on quality, compassion, and excellence
• The stability of a Florida-based, clinician-owned organization serving communities for over 10 years
• The opportunity to make a direct impact on patient access to care

At Elite, we believe in teamwork over hierarchy, support over burnout, and purpose over routine. Our clinicians and staff are the foundation of everything we do.

Disclaimer

The statements above are intended to describe the general nature and level of work being performed. They are not intended to be an exhaustive list of all responsibilities, duties, or qualifications. Management may assign additional duties as needed.

Equal Employment Opportunity

We are an Equal Opportunity Employer and consider all qualified applicants without regard to any characteristic protected by applicable law.

Reasonable Accommodation

Reasonable accommodations are available to qualified individuals with disabilities throughout the hiring process. Please contact Human Resources if needed.