Quality Assurance Manager

Benefits: 401(k) Competitive salary Dental insurance Health insurance Opportunity for advancement Paid time off Training & development Vision insurance Flexible schedule Responsible 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 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 o 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 What's Offered Competitive salary commensurate with experience comprehensive benefits package remote work environment opportunity to lead quality initiatives that directly impact patient outcomes and regulatory success Job Type: Full-time Benefits: 401(k) Dental insurance Employee assistance program Flexible schedule Health insurance Life insurance Paid time off Professional development assistance Vision insurance Experience: Home Health Hospice quality assurance/utilization review: 5 years (Preferred) License/Certification: WA State RN License REQUIRED Work Location: Remote Flexible work from home options available. Compensation: $85,000.00 - $95,000.00 per year We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Are you seeking a meaningful career with a professional and compassionate team? At Harbors Home Health and Hospice, a nonprofit organization, we prioritize work-life balance while delivering exceptional care. For over 40 years, we have proudly served as the leading community-based Home Health and Hospice agency in Grays Harbor and Pacific Counties. With offices in both Hoquiam and Long Beach, we ensure our clinical teams have the support they need to provide quality care to individuals and their families. Join us and make a real difference in the lives of those who need it most.

Created: 2026-03-04