NYS Registered Nurse professional license is require for this opportunity
Role and Responsibilities
The Home Care Quality Assurance (QA) Specialist is responsible for monitoring, evaluating, and improving the quality of care delivered by the home health agency. This role ensures compliance with CMS Conditions of Participation, State regulations, Star Ratings, Value-Based Purchasing (VBP), and internal quality standards. The QA Specialist collaborates with clinical leadership to analyze data, identify performance gaps, provide staff education and drive continuous quality improvement initiatives.
Essential Functions
Quality Monitoring & Auditing
- Conduct routine and targeted audits of clinical records for utilization review to ensure accuracy, completeness, and regulatory compliance
- Review OASIS documentation for clinical accuracy and impact on Star Ratings and VBP measures
- Ensure compliance with CMS, state, and accrediting body requirements
- Identify trends, deficiencies, and opportunities for improvement
- Assist with processing of workflow as requested
- Perform audits and identify trends related to hospitalizations
Education & Staff Support
- Provide feedback and education to clinicians (1:1 or group settings) regarding documentation best practices and quality standards
- Assist with development and delivery of quality-focused education and training programs
- Serve as a resource for staff related to quality measures, compliance, and performance outcomes
- Remain up to date on industry changes and maintain certifications
Collaboration & Communication
- Work closely with clinical leadership, clinical education, operations, and intake staff to improve patient outcomes and ensure clinical documentation is up to date with best practice standards and regulatory requirements
- Communicate quality findings clearly and professionally to interdisciplinary teams
- Participate in quality meetings and performance review discussions
- Other duties as assigned.
This job description reflects management’s assignment of essential functions; and nothing in this herein restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
Qualifications and Requirements
Required
- Licensed clinician (RN preferred; PT, OT, or other licensed home health clinician considered)
- Minimum of 2–3 years of home health experience
- Strong knowledge of OASIS, CMS regulations, and home health quality measures
- Experience with clinical documentation review and audits
- Strong analytical, organizational, and communication skills
- Computer literacy and experience with Microsoft Office
- Must have current, valid driver’s license and reliable transportation.
- Attention to detail
- Data-driven decision-making
- Continuous improvement mindset
Preferred
- Quality, compliance, or QAPI experience in home health
- Familiarity with EMR systems (HCHB) and quality reporting tools (SHP)
- Certification in healthcare quality or compliance (e.g., HCS-D, COS-C, or similar)
Work Environment
The Quality Assurance Specialist is primarily in an office setting and may be exposed to outdoor conditions.
The working conditions are classified as sedentary work:
- Sedentary work - Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.
- Occasional travel to branch offices or field staff meetings is required
Physical Requirements
The following is a description of the physical requirements on a daily basis for the Quality Assurance Specialist. While performing the duties of the job the employee is regularly expected to:
- Stand
- Sit
- Hear
- Walk
- Talk
- Stoop or kneel
- Repetitive motion
This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this is intended to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks be performed as assigned.
Skills Required
- Current NYS Registered Nurse professional license or another applicable licensed home health clinician credential
- Minimum of 2-3 years of home health experience
- Strong knowledge of OASIS, CMS regulations, and home health quality measures
- Experience with clinical documentation review and audits
- Strong analytical, organizational, and communication skills
- Computer literacy and Microsoft Office experience
- Current, valid driver's license and reliable transportation
- Attention to detail
- Data-driven decision-making skills
- Continuous improvement mindset
- Quality, compliance, or QAPI experience in home health
- Familiarity with HCHB EMR and SHP quality reporting tools
- Healthcare quality or compliance certification such as HCS-D or COS-C
What We Do
HCR Home Care, a leader in Home Health Care for over 45 years, is committed to providing the best quality patient care and superior service, and we now service 25 counties across New York State. HCR is an employee-owned company, offering YOU an active partnership in our business. Our employees play an important role in treating people and keeping them safe and healthy in the comfort of their own homes, and we believe our employees are the reason HCR is able to provide award-winning home care. Consider a career at HCR! We offer competitive pay and benefits, continuing education and training opportunities, and utilize state-of-the-art technology. HCR has been providing care management services through New York's Medicaid Health Home program since 2013. In 2016 HCR launched HCR Care Management, LLC, in support of this growing business. Care Managers oversee and provide access to services for patients enrolled in the program. We are continually looking for additional Care Managers and other support staff as we continue to expand this business.
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