Home Health RN Quality Assurance Reviewer

Compassionate Home Health LTD | Full-Time | Greater Sacramento Area Pay: $38–$45 per hour, depending on qualifications and experience Schedule: Full-time Reports to: Agency leadership About the Role Compassionate Home Health LTD is seeking an experienced Registered Nurse to join our team as a full-time Home Health Quality Assurance Reviewer. The reviewer will work closely with agency leadership to strengthen clinical documentation, OASIS accuracy, diagnosis coding, and compliance across home health services. The reviewer will examine OASIS assessments and patient records for clinical consistency, accurate diagnoses and severity, support for skilled services, and alignment with Medicare requirements, CMS Conditions of Participation, and ACHC standards. The reviewer will communicate findings and recommendations to clinicians and help staff improve documentation through education and feedback. Key Responsibilities Review OASIS assessments for completeness, accuracy, internal consistency, and support in the clinical record. Review primary and secondary diagnoses, ICD-10-CM coding, sequencing, specificity, and severity for consistency with the medical record and applicable guidance. Check that assessment responses reflect the patient’s documented condition and the assessing clinician’s findings. Identify missing, conflicting, or unclear documentation and communicate needed corrections or clarification to the appropriate clinician. Review plans of care, physician orders, visit notes, medication profiles, and supporting clinical records for completeness and consistency. Assess whether documentation supports homebound status, medical necessity, skilled need, goals, interventions, and ordered services. Review records for alignment with Medicare home health requirements, CMS Conditions of Participation, OASIS guidance, and ACHC standards. Help prepare records for ADR, pre-claim review, and other payer or regulatory reviews, as assigned. Track review findings, correction requests, and recurring documentation trends. Provide practical education and feedback to Skilled Nursing, Physical Therapy, and Home Health Aide staff. Work with agency leadership on quality improvement, documentation standards, and audit readiness. Protect patient confidentiality and follow agency policies and applicable privacy requirements. Qualifications Current, unrestricted Registered Nurse license in California. Recent home health experience, including familiarity with OASIS assessments and home health documentation. Strong knowledge of Medicare home health eligibility, homebound criteria, medical necessity, skilled services, and Conditions of Participation. Experience reviewing diagnosis coding, ICD-10-CM specificity, sequencing, and clinical support in home health records. Knowledge of ACHC standards and survey-readiness practices preferred. Strong written and verbal communication skills, sound clinical judgment, and close attention to detail. Ability to organize review work, meet deadlines, and provide respectful, constructive feedback. OASIS or home health coding certification—such as COS-C, HCS-O, COQS, or HCS-D is preferred. Benefits Health insurance Paid time off Five days of sick leave 401(k) with a 4% company match Paid holidays Professional development and continuing education support Important Role Clarification The reviewer evaluates documentation and provides findings or recommendations. The clinician who completed the assessment remains responsible for the clinical assessment and OASIS responses; the reviewer does not substitute their judgement for the assessing clinician’s findings. Compassionate Home Health LTD is an equal opportunity employer. #J-18808-Ljbffr Compassionate Home Health Ltd