[Remote] Clinical Quality Assurance Specialist
Note: The job is a remote job and is open to candidates in USA. Humana, a leading U.S. healthcare company, is seeking a Clinical Quality Assurance Specialist to enhance patient care and ensure regulatory compliance. The role involves collaborating with clinical teams, providing education, conducting audits, and supporting quality improvement initiatives.
Responsibilities
- Collaborate with branch leadership to develop and implement quality assurance and performance improvement strategies
- Provide education and coaching to field clinicians and case managers, including instructor-led sessions
- Support branches in regulatory compliance, survey readiness, and quality improvement plans
- Help with new hire onboarding and training focused on clinical documentation, OASIS, and regulatory requirements
- Conduct chart audits and data analysis, delivering applicable feedback to improve clinical quality and compliance
- Monitor and support quality investigations and compliance processes
- Partner with leadership to identify trends, gaps, and opportunities for improvement
- Contribute to special projects and organizational plans as assigned
Skills
- Current state license as a Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist
- Home health experience
- Proficiency in OASIS, CMS regulations, and clinical documentation standards
- 2+ years of training and learning development experience
- Understanding of curriculum design and adult learning principles
- Experience using several training tools to facilitate to a wide audience
- COS-C certification
- Experienced with Wellsky/Kinnser or comparable healthcare EMR platforms
- Bilingual (English and Spanish speaker)
Benefits
- Bonus incentive plan
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- Short-term and long-term disability
- Life insurance
Company Overview
Company H1B Sponsorship