Clinical QA Nurse (RN) – AI Platform Quality Assurance
claim-health · New York City
Job description
About the role
We're hiring a Registered Nurse with deep home health and hospice experience to own the clinical quality of the documentation flowing through our AI platform. You will ensure automations make clinically sound decisions, identify failures, and continuously improve accuracy.
Key responsibilities
- Audit clinical QA performance by reviewing charts processed by the automation platform for accuracy, completeness, and consistency.
- Improve clinical automation logic in partnership with engineering and product teams, identifying missed nuances and validating rule changes.
- Build clinical review standards and SOPs that define how documentation should be reviewed across home health and hospice.
- Support customer implementations by understanding agency workflows and configuring automations to match their processes.
- Drive quality metrics, measuring documentation quality, automation accuracy, exception rates, and rework to identify improvement opportunities.
Required profile
- Active RN license (NY or compact license preferred).
- 3+ years of home health and/or hospice clinical experience.
- Strong understanding of OASIS documentation and home health eligibility requirements.
- Experience reviewing physician orders, certifications, plans of care, face‑to‑face documentation, and hospice election paperwork.
- Hands‑on experience with HomeCare HomeBase (HCHB), Axxess, and WellSky; KanTime a plus.
- Strong knowledge of Medicare home health and hospice documentation requirements.
- Experience writing SOPs, QA guidelines, or training documentation.
- Excellent attention to detail and pattern recognition.
- Comfortable working in a fast‑paced startup environment.
Required skills
- HomeCare HomeBase
- Axxess
- WellSky
- KanTime
- Careport
- Forcura
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Published 2 weeks ago
Expires 1 month from now
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claim-health
New York City
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