Clinical Quality Assurance Specialist

Become a part of our caring community The Clinical Quality Assurance Specialist partners closely with clinical teams and branch leadership to drive excellence in patient care, regulatory compliance, and performance improvement. You will serve as a subject matter expert, providing guidance, education, and data-driven insights to ensure high-quality clinical outcomes and adherence to industry standards. Assignments are varied and require independent judgment, critical thinking, and proactive decision-making. You will report to Quality Assurance Director. Use your skills to make an impact Responsibilities Collaborate with branch leadership to develop and implement quality assurance and performance improvement strategies Provide education and coaching to field clinicians and case managers, including instructor-led sessions Support branches in regulatory compliance, survey readiness, and quality improvement plans Help with new hire onboarding and training focused on clinical documentation, OASIS, and regulatory requirements Conduct chart audits and data analysis, delivering applicable feedback to improve clinical quality and compliance Monitor and support quality investigations and compliance processes Partner with leadership to identify trends, gaps, and opportunities for improvement Contribute to special projects and organizational plans as assigned Required Qualifications Current state license as a Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist. Home health experience Proficiency in OASIS, CMS regulations, and clinical documentation standards. 2+ years of training and learning development experience Understanding of curriculum design and adult learning principles Experience using several training tools to facilitate to a wide audience. Preferred Qualification COS-C certification Experienced with Wellsky/Kinnser or comparable healthcare EMR platforms Bilingual (English and Spanish speaker) Additional Information Normal Hours of Operation: M-F 8:00a - 5:00p (ET) Remote (may be required to travel to branch as needed) Branch Location: 3351 Executive Way Miramar, FL 33025 Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family. About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana