[Hiring] Quality Assurance Manager @Harbors Home Health & Hospice

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role is responsible for leading agency wide quality, compliance, and utilization management initiatives. Key responsibilities include: • Provide leadership and oversight for Quality Assurance, Performance Improvement (QAPI), and Utilization Review programs for home health and hospice • Ensure compliance with CMS Conditions of Participation, state regulations, accreditation standards, and payer requirements • Oversee utilization review processes to ensure medical necessity, appropriate level of care, and regulatory compliance • Lead survey readiness efforts and serve as a key resource during state, CMS, and accreditation surveys • Analyze quality data, outcomes, denials, trends, and audit findings, develop corrective action plans and monitor effectiveness • Collaborate with clinical leadership to improve documentation quality, care planning, and interdisciplinary coordination • Provide guidance and oversight related to OASIS accuracy, hospice eligibility, and regulatory documentation standards • Develop, implement, and maintain QA/UR policies, procedures, and education programs • Support coding, billing, and reimbursement integrity initiatives • Stay current on regulatory changes impacting home health and hospice and proactively implement organizational responses Qualifications • Active WA State RN License • Minimum of 5-7 years experience in home health and/or hospice quality, compliance, or utilization review • Strong working knowledge of CMS regulations, COPs, QAPI, OASIS, PDGM, hospice eligibility, and utilization management • Experience with survey management, audits, corrective action plans and regulatory investigations • Demonstrated ability to analyze data, identify risk, and drive performance improvement • Excellent communication, leadership, and stakeholder engagement skills Requirements • Home Health Hospice quality assurance/utilization review: 5 years (Preferred) • WA State RN License REQUIRED Benefits • 401(k) • Competitive salary • Dental insurance • Employee assistance program • Flexible schedule • Health insurance • Life insurance • Paid time off • Professional development assistance • Vision insurance Company Description Flexible work from home options available.