Quality Assurance RN

Adaptive Home Health is building a higher-acuity, patient-centered home health model across Michigan. Our QA RN role is critical to that mission: you ensure clinical accuracy, regulatory compliance, and optimal reimbursement while supporting field clinicians with actionable feedback and continuous quality improvement.

We build technology to better support our clinical operations and compliance teams. Our documentation and QA workflows are designed to streamline OASIS review, reduce rework, and maintain defensible, high-quality submissions.

If you have sharp clinical judgment, deep OASIS expertise, and you thrive in a remote, productivity-based environment, this role offers meaningful impact on patient outcomes and agency performance.

• Review and validate all assigned OASIS assessments (SOC, ROC, Recert, Transfer, Discharge) for accuracy, completeness, and internal consistency

• Code and sequence diagnoses per ICD-10 and CMS guidelines to ensure optimal reimbursement and quality measure alignment

• Identify and correct errors impacting reimbursement, quality measures, or compliance before submission

• Provide clear, actionable feedback to field clinicians when revisions are required, with a focus on education and process improvement

• Ensure all OASIS submissions meet current CMS, Medicare, and payer requirements

• Stay current on OASIS updates, CMS guidance, and regulatory changes; communicate relevant updates to clinical leadership

• Support agency compliance with Conditions of Participation (CoPs) and internal quality standards

• Identify recurring documentation trends or risk areas and contribute recommendations for clinician training and workflow optimization

• Collaborate with clinical leadership to improve outcomes, reduce audit risk, and maintain defensibility

• Complete assigned OASIS reviews within defined turnaround times while maintaining high accuracy standards

• Communicate promptly and professionally with clinicians and leadership regarding discrepancies, missing documentation, or process improvements

• Clear, performance-based comp: $35 per locked OASIS review—earn based on quality and productivity

• Remote flexibility: Work from home with flexible hours designed to scale with agency census

• Mission-driven impact: Directly influence patient care quality, clinician development, and agency compliance

• Strong operational support: Collaborate with experienced clinical and compliance leadership

• Tech-forward environment: Leverage tools designed to streamline QA workflows and reduce administrative burden

Must-haves

• Active, unrestricted Michigan RN license

• Minimum 2 years of home health experience

• ICD-10 Coding Certification (HCS-D or equivalent)

• OASIS Certification (COS-C or equivalent)

• Strong understanding of Medicare home health reimbursement and PDGM

• High attention to detail and strong clinical judgment

• Ability to work independently in a remote environment with minimal supervision

• Excellent written and verbal communication skills

• Proficiency with EMR systems (HCHB preferred) and Microsoft Office

Nice-to-haves

• Prior experience in home health QA, auditing, or coding

• Familiarity with Homecare Homebase (HCHB) or AXXESS

• Experience working in a per-review or productivity-based role

• Background in OASIS education or clinician training

• Accurate and compliant OASIS reviews with minimal rework

• Consistent turnaround times aligned with agency workflow needs

• Clear, professional, and constructive communication with clinicians and leadership

• Ongoing adherence to quality and compliance standards

• Proactive identification of trends and process improvement opportunities

• Ability to work at a computer for extended periods

• Reliable high-speed internet access and secure, HIPAA-compliant workspace

• Proficiency with EMR systems, Microsoft Office, and virtual communication tools (Slack, Zoom, etc.)

  Equal Opportunity We are an equal opportunity employer and value diversity. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.