Quality Assurance Manager

Benefits:401(k)Competitive salaryDental insuranceHealth insuranceOpportunity for advancementPaid time offTraining & developmentVision insuranceFlexible scheduleResponsible for leading agency wide quality, compliance, and utilization management initiatives. This role is responsible for ensuring regulatory compliance, driving clinical excellence, optimizing reimbursement, and supporting survey readiness across home health and hospice programs.The ideal candidate is a strategic leader with deep knowledge of CMS regulations, Conditions of Participation, OASIS, hospice eligibility, and utilization review processes, with the ability to partner effectively with clinical, operational, and executive teams.Provide leadership and oversight for Quality Assurance, Performance Improvement (QAPI), and Utilization Review programs for home health and hospiceEnsure compliance with CMS Conditions of Participation, state regulations, accreditation standards, and payer requirementsOversee utilization review processes to ensure medical necessity, appropriate level of care, and regulatory complianceLead survey readiness efforts and serve as a key resource during state, CMS, and accreditation surveysAnalyze quality data, outcomes, denials, trends, and audit findings, develop corrective action plans and monitor effectivenessCollaborate with clinical leadership to improve documentation quality, care planning, and interdisciplinary coordinationProvide guidance and oversight related o OASIS accuracy, hospice eligibility, and regulatory documentation standardsDevelop, implement, and maintain QA/UR policies, procedures, and education programsSupport coding, billing, and reimbursement integrity initiativesStay current on regulatory changes impacting home health and hospice and proactively implement organizational responsesQualificationsActive WA State RN LicenseMinimum of 5-7 years experience in home health and/or hospice quality, compliance, or utilization reviewStrong working knowledge of CMS regulations, COPs, QAPI, OASIS, PDGM, hospice eligibility, and utilization managementExperience with survey management, audits, corrective action plans and regulatory investigationsDemonstrated ability to analyze data,. identify risk, and drive performance improvementExcellent communication, leadership, and stakeholder engagement skillsWhat's OfferedCompetitive salary commensurate with experiencecomprehensive benefits packageremote work environmentopportunity to lead quality initiatives that directly impact patient outcomes and regulatory successJob Type: Full-timeBenefits:401(k)Dental insuranceEmployee assistance programFlexible scheduleHealth insuranceLife insurancePaid time offProfessional development assistanceVision insuranceExperience:Home Health Hospice quality assurance/utilization review: 5 years (Preferred)License/Certification:WA State RN License REQUIREDWork Location: RemoteFlexible work from home options available.

Created: 2026-03-04