Quality Assurance Manager Jobot
Buena Park, CA5 days ago
- $115,000–$145,000 Per Year
AMERICADE HOME HEALTH AGENCY
- WESTMINSTER, CA
- 13 days ago
- Full-time
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Skills
- Auditingunmatched
- Billingunmatched
- Centers for Medicare and Medicaid Services (CMS)unmatched
- Clinical Monitoringunmatched
- Clinical Study Publicationsunmatched
- Communication Skillsunmatched
- Content Management Systems (CMS)unmatched
- Continuous Improvementunmatched
- Corrective Actionunmatched
- Current Procedural Terminology (CPT)unmatched
- DSL (Digital Subscriber Line)unmatched
- Data Analysisunmatched
- Detail Orientedunmatched
- Documentationunmatched
- Documentation Reviewunmatched
- HIPAA (Health Insurance Portability and Accountability Act)unmatched
- Health Insuranceunmatched
- Healthcareunmatched
- Home Careunmatched
- Homeland Securityunmatched
- ICD-10unmatched
- ICD-9unmatched
- Information/Data Security (InfoSec)unmatched
- Interpret Regulationsunmatched
- Legalunmatched
- Maintain Complianceunmatched
- Managed Careunmatched
- Medicaidunmatched
- Medical Codingunmatched
- Medical Protocolsunmatched
- Medical Record Systemunmatched
- Medical Terminologyunmatched
- Medicareunmatched
- Medicationsunmatched
- Patient Safetyunmatched
- Presentation/Verbal Skillsunmatched
- Privacy Controlsunmatched
- Program Evaluationunmatched
- Project/Program Managementunmatched
- Quality Assuranceunmatched
- Quality Assurance Methodologyunmatched
- Quality Managementunmatched
- Quality of Careunmatched
- Record Keepingunmatched
- Regulationsunmatched
- Regulatory Complianceunmatched
- Regulatory Requirementsunmatched
- Safety Standardsunmatched
- Standards of Careunmatched
- The Joint Commission (TJC)unmatched
- Writing Skillsunmatched
Description
Job Summary
We are seeking a dedicated and detail-oriented in office Home Health Quality Assurance (QA) to ensure the highest standards of care and compliance within our home health agency. In this vital role, you will oversee quality assurance processes, monitor adherence to healthcare regulations, and support continuous improvement initiatives. Your expertise will help maintain compliance with federal, state, and local healthcare policies, including CMS regulations, HIPAA privacy standards, and The Joint Commission accreditation requirements. This position offers an exciting opportunity to impact patient safety and service excellence in a dynamic healthcare environment.
Responsibilities
We are seeking a dedicated and detail-oriented in office Home Health Quality Assurance (QA) to ensure the highest standards of care and compliance within our home health agency. In this vital role, you will oversee quality assurance processes, monitor adherence to healthcare regulations, and support continuous improvement initiatives. Your expertise will help maintain compliance with federal, state, and local healthcare policies, including CMS regulations, HIPAA privacy standards, and The Joint Commission accreditation requirements. This position offers an exciting opportunity to impact patient safety and service excellence in a dynamic healthcare environment.
Responsibilities
- Conduct comprehensive audits of electronic health records using Data Soft Logic (DSL) to verify accuracy, completeness, and compliance with Medicare and managed care policies.
- Review clinical documentation for adherence to medical terminology standards, CPT coding, ICD-9/ICD-10 coding accuracy, and proper billing practices.
- Ensure compliance with HIPAA privacy and security regulations during all data handling activities.
- Monitor clinical workflows to confirm alignment with DHS regulations and healthcare law requirements.
- Collaborate with clinical staff to identify areas for quality improvement based on audit findings and regulatory updates.
- Maintain detailed records of audits, corrective actions, and compliance reports in accordance with The Joint Commission standards.
- Stay current on CMS regulatory changes and health regulation policies to inform ongoing quality assurance strategies.
- Strong understanding of HIPAA privacy rules and security standards for protected health information (PHI).
- Proficiency in CPT coding, ICD-9/ICD-10 coding systems, and medical terminology.
- Knowledge of CMS regulations related to Medicare and Medicaid home health services.
- Experience with DSL system for documentation review and data analysis (PREFERRED).
- Familiarity with The Joint Commission regulations impacting healthcare documentation and medication management.
- Ability to interpret healthcare laws such as the Medical Law Act and manage compliance with health regulation policies.
- Project management skills within a healthcare setting to coordinate audits, training sessions, and quality improvement initiatives.
- 3+ years previous home health QA experience (REQUIRED)
- Experience with developing, implementing, and evaluating quality management programs and activities in a home health setting
- Excellent verbal and written communication skills required
Numbers & Facts
| Location | WESTMINSTER, CA |
| Job Type | Full-time |
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