RN Manager of Home Health Quality AssuranceJOB SUMMARYThe Home Health Quality Assurance (QA) Manager leads the agency's Quality Assessment and Performance Improvement (QAPI) program and oversees documentation and clinical quality processes that support safe, compliant, and high-performing patient care in the home. This role partners with the Administrator, Clinical Manager(s), Therapy and Nursing leadership, and the governing body to ensure an effective, ongoing, data-driven QAPI program aligned with CMS Home Health Conditions of Participation (CoPs), including 42 CFR A7484.65.
BENEFITSUT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:
- PPO medical plan, available day one at no cost for full-time employee-only coverage
- 100% coverage for preventive healthcare-no copay
- Paid Time Off, available day one
- Retirement Programs through the Teacher Retirement System of Texas (TRS)
- Paid Parental Leave Benefit
- Wellness programs
- Tuition Reimbursement
- Public Service Loan Forgiveness (PSLF) Qualified Employer
- Learn more about these and other UTSW employee benefits!
EXPERIENCE AND EDUCATIONRequired- Education
Bachelor's Degree in nursing
- Experience
5 years of progressive clinical experience, with at least 2 years in Medicare-certified Home Health and
2 years in quality, compliance, QA, clinical documentation review, OASIS review/education, or QAPI leadership (may be combined across roles).Must be able to fulfill role of Nurse Supervisor in alignment with State of Texas requirements.
- Licenses and Certifications
OASIS Credential: COS-C or equivalent OASIS-focused credential/training within 1 Year
Preferred- Licenses and Certifications
(CPHQ) Cert Pro in Hlthcr Quality
Formal QAPI / performance improvement training (Preferred): documented training in QAPI methods (PDSA/Lean/Six Sigma) and regulatory quality program operations.
Home health coding/clinical documentation credential (Preferred, role-dependent): HCS-O / HCS-D or similar home health assessment/coding credential.
JOB DUTIES- Develop, implement, evaluate, and maintain an effective, ongoing, agency-wide, data-driven QAPI program in alignment with 42 CFR A7484.65.
- Establish measurable quality priorities, performance indicators, and a governance cadence (e.g., monthly QAPI meetings) with documented minutes, actions, and follow-up.
- Lead Performance Improvement Projects (PIPs) using structured methodologies (e.g., PDSA/Lean) that address high-risk, high-volume, or problem-prone areas and patient safety.
- Ensure the QAPI program uses data from multiple sources (clinical records, OASIS/QA reviews, patient feedback, incidents, infection prevention, utilization/readmissions) and results in sustained improvement.
- Prepare QAPI reports/dashboards for the Administrator and governing body; elevate quality risks and recommend corrective actions.
- Oversee OASIS accuracy and integrity (SOC/ROC/Discharge/Transfer), ensuring alignment with CMS guidance and internal policy.
- Develop and manage pre-bill/clinical record review processes to confirm medical necessity, plan-of-care alignment, and defensible documentation for each visit note.
- Collaborate with clinical leadership to set documentation standards (timeliness, completeness, consistency) and reduce denials/ADR risk through proactive improvement.
- Provide targeted coaching and education to clinicians on OASIS, care planning, and documentation quality; track remediation completion and outcomes.
- Maintain continuous survey readiness for CMS and accrediting bodies by ensuring CoP alignment across clinical operations and documentation.
- Perform routine compliance audits (e.g., timeliness of assessments, care planning, orders, discharge planning, infection prevention practices) and track corrective actions to closure.
- Coordinate responses to findings (internal audits, state survey, accreditation) including Plans of Correction (POCs), evidence submission, and sustainment monitoring.
- Partner with clinical leaders to ensure timely investigation and trending of incidents, complaints, and adverse events; ensure lessons learned are embedded into practice.
- Monitor key quality and operational metrics such as OASIS data quality, timeliness measures, missed visits, infection events, hospitalization/readmission rates, patient satisfaction, and clinical outcomes.
- Develop and maintain actionable dashboards and audit tools; ensure data definitions, validation, and accountability for metric owners.
- Identify performance gaps and root causes; translate findings into practical workflow changes, education, and measurable targets.
- Collaborate with Finance/Revenue Cycle on claim quality indicators and denial prevention strategies (e.g., medical review/ADR readiness).
- Design and deliver quality-focused training for onboarding and ongoing competency (documentation, OASIS, CoP standards, patient safety).
- Support leaders in implementing standardized workflows, checklists, and competency tools that sustain improvement.
- Other duties as assigned
