Quality Assurance Registered Nurse

Role Overview

• Review and validate all assigned OASIS assessments (SOC, ROC, Recert, Transfer, Discharge) for accuracy, completeness, and internal consistency
• Code and sequence diagnoses per ICD-10 and CMS guidelines to ensure optimal reimbursement and quality measure alignment
• Identify and correct errors impacting reimbursement, quality measures, or compliance before submission
• Provide clear, actionable feedback to field clinicians when revisions are required, with a focus on education and process improvement
• Ensure all OASIS submissions meet current CMS, Medicare, and payer requirements
• Stay current on OASIS updates, CMS guidance, and regulatory changes; communicate relevant updates to clinical leadership
• Support agency compliance with Conditions of Participation (CoPs) and internal quality standards
• Identify recurring documentation trends or risk areas and contribute recommendations for clinician training and workflow optimization
• Collaborate with clinical leadership to improve outcomes, reduce audit risk, and maintain defensibility
• Complete assigned OASIS reviews within defined turnaround times while maintaining high accuracy standards
• Communicate promptly and professionally with clinicians and leadership regarding discrepancies, missing documentation, or process improvements

Requirements

• Active, unrestricted Michigan RN license
• Minimum 2 years of home health experience
• ICD-10 Coding Certification (HCS-D or equivalent)
• OASIS Certification (COS-C or equivalent)
• Strong understanding of Medicare home health reimbursement and PDGM
• High attention to detail and strong clinical judgment
• Ability to work independently in a remote environment with minimal supervision
• Excellent written and verbal communication skills
• Proficiency with EMR systems (HCHB preferred) and Microsoft Office
• Prior experience in home health QA, auditing, or coding (nice-to-have)

Benefits

• Clear, performance-based comp: $35 per locked OASIS review—earn based on quality and productivity
• Remote flexibility: Work from home with flexible hours designed to scale with agency census
• Mission-driven impact: Directly influence patient care quality, clinician development, and agency compliance
• Strong operational support: Collaborate with experienced clinical and compliance leadership
• Tech-forward environment: Leverage tools designed to streamline QA workflows and reduce administrative burden