Clinical Quality Manager

Reposted 2 Days Ago
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Hiring Remotely in USA
Remote
Senior level
Artificial Intelligence • Healthtech • Software
The Role
The Clinical Quality Manager supports field clinical teams by ensuring accuracy in EMR workflows, order management, compliance, and quality assurance in home health care. They identify issues, implement process improvements, and monitor patient statuses.
Summary Generated by Built In

Michigan RN license required.

About Us

We are fixing US healthcare by building an AI-native physical care platform, starting with home health. We’ve built one of the best AI teams in the world (from Character AI, Scale, Palantir, Citadel, Jane Street) and paired them with a team of healthcare veterans to build a new type of healthcare company: one that delivers care at the speed of an AI company.

Our centralized team of Clinical Quality Managers assume responsibility for many HCHB and back-office clinical functions. This centralized role is purpose-built to focus on accuracy, timeliness, regulatory compliance, and efficient process. This critical role relieves a portion of the administrative burden for branch teams, allowing Branch Clinical Managers to fully focus on active management of patient care and clinician skill development.

Position Type: Remote, centralized position supporting multiple branch clinical field teams.

Position Overview

The Clinical Quality Manager is a centralized, remote RN role that provides clinical backbone support to the field clinical team. This is not a field position — the Clinical Quality Manager operates from a central hub to ensure that orders, EMR workflows, back-office clinical functions, and regulatory and billing compliance tasks are completed with accuracy and timeliness.

The Clinical Quality Manager brings the knowledge and expertise of a registered nurse to back-office functions that require clinical oversight — processing and approving orders, monitoring patient status flags in EMR/dashboards, and supporting quality and compliance tracking. This role is purpose-built to take high-volume, process-intensive clinical tasks off the branch Clinical Manager's plate so that the branch Clinical Manager can focus on direct clinical oversight, coaching, and rehospitalization prevention in the field.

This is NOT a passive support role. The Clinical Quality Manager is accountable for timely, accurate clinical decision-making within the EMR. You will own workflows that directly affect patient safety, billing integrity, and regulatory compliance.

What You'll Do

Drive quality, safety, and compliance through systems

  • Identify recurring clinical and documentation issues and implement process improvements

  • Support quality assurance activities by ensuring clinical work meets standards before downstream review

Order management & EMR workflow execution

  • Review and approve new orders in EMR; ensuring:

    • compliance with documentation standards for verbal orders

    • orders are complete and address patient care needs

  • Complete clinical escalation reviews at intake to support referral processing

End of episode management

  • Review daily discharge reports; verify DC summaries and signed orders are complete and accurate

  • Confirm NOMNC is on file for all appropriate discharges

  • Process discipline-only and full discharge orders as they arise

Hospital Hold Process Management

  • Manage hospital hold information, inpatient transfer processes, and POC completion for hospitalized patients

  • Discharge clients in facility at end of episode as needed

  • Manage resumption of care workflows, ensure timely resumption of care, oversee pending delay approvals in the EMR

Quality & Compliance Monitoring

  • Review and track infection control reports

  • Monitor for wound score deviations and escalate appropriately

  • Review and trend QI events weekly; identify patterns and flag for clinical leadership

  • Review and process clinical alerts and potentially avoidable event notifications

  • Audit missed visits by clinician and unverified missed visits daily to support appropriate care delivery as well as LUPA risk management; confirm proper documentation and follow-up

Patient Status Monitoring

  • Monitor vital sign parameter alerts for active patients, ensuring appropriate documentation, notifications, and follow-up; escalating to branch Clinical Manager as appropriate

  • Review coordination notes for physician updates, medication interactions, and clinically significant medication issues

  • Review dashboards for change-in-condition with appropriate clinical judgment and escalation

Who You Are

A detail-oriented, systems-driven RN who finds satisfaction in executing complex workflows with precision and timeliness. You are comfortable working independently in a remote environment and thrive in a role where your EMR proficiency and clinical knowledge directly protect patient safety and compliance integrity.

Must-haves

  • Active RN license (Michigan license required) — clinical judgment is core to this role

  • Strong EMR proficiency with HCHB

  • Exceptional attention to detail and commitment to documentation accuracy

  • Ability to manage high-volume, time-sensitive workflows without losing quality

  • Understanding of home health regulatory requirements

  • Ability to work independently and manage time effectively in a remote environment

  • Clear written and verbal communication; ability to escalate clinical concerns appropriately

Skills Required

  • Active RN license
  • Strong EMR proficiency with HCHB
  • Exceptional attention to detail
  • Ability to manage high-volume workflows
  • Understanding of home health regulatory requirements
  • Ability to work independently in a remote environment
  • Clear written and verbal communication
Am I A Good Fit?
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The Company
22 Employees
Year Founded: 2024

What We Do

Fira Health is building an AI-enabled, AI-native physical care platform, starting with home health. They develop clinical software and agentic AI tools to transform administrative workflows, helping agencies reduce administrative burden, get paid faster, and focus more on patient care.

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