Join VitalCaring – Where Your Expertise Protects Patient Care
Regulatory Review Specialist (RN) – Home Office (Remote)Who We AreFounded in 2021, VitalCaring has quickly become a leading provider of home health and hospice services across the country. Our mission is simple: deliver exceptional patient care while creating a workplace where team members feel supported, empowered, and inspired.
At VitalCaring, quality and compliance are more than requirements—they’re essential to ensuring patients receive the right care at the right time. We are seeking a highly detail-oriented Regulatory Review Specialist (RN) to join our Clinical Regulatory Compliance team and help drive excellence across our organization.
Why Join VitalCaring?
Make a Meaningful Impact
Your expertise will directly support regulatory readiness, compliance excellence, and quality outcomes that protect patient care.
Be Part of Something Bigger
Partner cross-functionally with clinical, operational, billing, and compliance teams to strengthen processes and maintain regulatory integrity.
Work with Purpose and Flexibility
Enjoy the ability to work independently in a remote environment while contributing to high-impact initiatives across the organization.
Grow Your Expertise
Expand your knowledge of healthcare regulations, medical review processes, payer requirements, and compliance strategy.
Position Overview
The Regulatory Review Specialist (RN) serves as a key member of the Clinical Regulatory Compliance team, supporting medical reviews, audit response activities, and regulatory documentation processes across home health and hospice operations.
In this role, you will coordinate and compile documentation for payer audits, CMS and contractor medical reviews, appeals, internal monitoring activities, and compliance initiatives. Success in this role requires strong clinical judgment, exceptional organization, regulatory knowledge, and the ability to thrive in a remote environment.
What You’ll Do
- Support payer audits and medical record reviews, ensuring timely and accurate submission of requested documentation
- Manage medical review requests and appeals associated with CMS contractors, regulatory agencies, and billing intermediaries
- Review clinical documentation using established audit and submission checklists
- Partner with operational and clinical teams to gather and validate required records
- Participate in chart reviews and compliance monitoring initiatives across the organization
- Assist with risk identification activities and regulatory readiness efforts
- Support investigations and corrective actions related to compliance findings
- Maintain audit tracking and outcomes through documentation systems and reporting tools
- Navigate multiple EMRs, payer portals, and operational systems to manage submissions and appeals
- Contribute to training and educational materials that strengthen compliance knowledge across teams
- Participate in internal quality, billing, and operational review activities
- Complete additional regulatory and administrative projects as assigned
- Current Registered Nurse (RN) license OR Licensed Practical Nurse (LPN)
- Minimum 3 years of clinical operational leadership or supervision experience within Home Health and/or Hospice
- Strong knowledge of CMS Home Health regulations and state/federal licensing standards
- Experience performing clinical chart reviews and documentation audits
- Ability to independently prioritize and manage work in a remote environment
- Strong technical skills and comfort navigating multiple systems and portals
- Excellent communication, organization, and follow-through
- Medical review, appeals, audit response, or utilization review experience
- Exposure to payer audits and contractor review processes
- Experience supporting compliance, quality, accreditation, or regulatory initiatives
- Experience with EMR platforms and documentation tracking systems
- Background working with billing, reimbursement, or operational compliance functions
Benefits
Health & Wellness
Medical, Dental, and Vision coverage
Pharmacy benefits
Virtual care and mental health support
Flexible Spending Accounts (FSA) and Health Savings Account (HSA)
Supplemental health and life insurance
Financial & Protection
401(k) with company match
Employee referral program
Prepaid legal services
Identity theft protection
Work-Life Balance & Perks
Generous paid time off
Pet insurance
Tuition and continuing education reimbursement
At VitalCaring, our values - trustworthy, capable, compassionate, proactive, and called - guide how we care for our patients and support each other every day.
Apply today and lead care that truly matters.
All employment decisions are made without regard to race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other protected characteristic. Candidates are evaluated based on job-related qualifications, skills, and business needs.
Skills Required
- Current Registered Nurse (RN) license
- Minimum 3 years clinical operational leadership or supervision experience within Home Health and/or Hospice
- Strong knowledge of CMS Home Health regulations and state/federal licensing standards
- Experience performing clinical chart reviews and documentation audits
- Ability to independently prioritize and manage work in a remote environment
- Strong technical skills and comfort navigating multiple systems and portals
- Excellent communication, organization, and follow-through
- Medical review, appeals, audit response, or utilization review experience
- Exposure to payer audits and contractor review processes
- Experience supporting compliance, quality, accreditation, or regulatory initiatives
- Experience with EMR platforms and documentation tracking systems
- Background working with billing, reimbursement, or operational compliance functions
What We Do
VitalCaring delivers compassionate, high quality home-based healthcare to patients in the comfort of their own home. By bringing together like-minded people who are called to care and supported by a positive organizational culture, our care teams are best positioned to deliver an exceptional patient experience at every encounter. VitalCaring is a national leader in the home health care and hospice industry serving patients throughout the Southern United States, including Texas, Oklahoma, Louisiana, Mississippi, Alabama and Florida. From its base in the Southeast, VitalCaring is expanding to serve even more communities nationwide.
