Clinical Quality Auditor - Remote

Elara Caring; Dallas (TX); On-site; USD 80,000 - 85,000; Full time

Benefits offered by this job

Competitive compensation package

Tuition reimbursement for full-time

Continuing education opportunities

Advancement opportunities

Comprehensive insurance plans

401(K) with employer match

Paid time off and holidays

Pet bereavement

Pet insurance

Job summary

Elara Caring is seeking a Clinical Quality Auditor to perform comprehensive audits across home health, hospice, and behavioral health segments. You will ensure Medicare/Medicaid compliance and focus on ICD-10 coding, OASIS, VBP, Care Compare, and clinical documentation to drive quality outcomes.

The role reports to the Manager of Quality Assurance and offers growth opportunities, strong benefits, and competitive pay.

Qualifications

• Associate degree in Nursing is required.
• 3 years of RN experience in home health or hospice.
• Current state RN license.
• HCS-D or HCS-H certification, or willingness to obtain within 6 months.
• COS-C certification, or willingness to obtain within 6 months.
• CHS-C certification, or willingness to obtain within 6 months.
• Strong written and verbal communication skills.
• Proven organizational development and project management skills.
• Knowledge of regulations and reimbursement in home health, hospice, and behavioral health.
• Ability to maintain confidentiality of sensitive information.

Responsibilities

• Perform comprehensive audits within skilled home health, hospice, and behavioral health agencies.
• Ensure compliance with Medicare and Medicaid regulations.
• Focus on ICD-10 coding, OASIS, VBP, Care Compare, and clinical documentation.
• Report to the Manager of Quality Assurance.
• Full job description will be provided.

Skills

Excellent communication

Organizational development

Project management

Confidentiality

Education

Associate degree in Nursing

Tools

HCS-D/HCS-H

COS-C

CHS-C

Job description

At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place.

Job Description

The Clinical Quality Auditor performs comprehensive audits within the skilled home health, hospice, and behavioral health agencies at Elara Caring to ensure compliance with Medicare and Medicaid regulations. The Auditor’s areas of focus to ensure quality outcomes will include, but are not limited to, ICD-10 coding, Outcome and Assessment Information Set (OASIS), Value Based Purchasing (VBP), Care Compare, and clinical documentation.

At Elara Caring, we care where you are and believe the best place for your care is where you live. We know there’s no place like home, and that’s why our teams continue to provide high-quality care to more than 60,000 patients each day in their preferred home setting. Wherever our patients call home and wherever they are on their health journey, we care. Each team member has a part to play in this mission. This means you have countless ways to make a difference as a Clinical Quality Auditor, by keeping a team of elite healthcare professionals operational.

To continue to be an industry pioneer delivering unparalleled care, we need a Clinical Quality Auditor who shares our commitment to distinction and progress.

Are you one of them?

Why Join the Elara Caring mission?

• Work in a collaborative environment.
• Be rewarded with a unique opportunity to make a difference
• Competitive compensation package
• Tuition reimbursement for full-time staff and continuing education opportunities for all employees at no cost
• Opportunities for advancement
• Comprehensive insurance plans for medical, dental, and vision benefits
• 401(K) with employer match
• Paid time off, paid holidays, family, and pet bereavement
• Pet insurance

What is Required?

• Associate degree in Nursing is required
• 3 years of experience as a Registered Nurse in home health and/or hospice
• Current state license as a Registered Nurse
• Certified Homecare Coding Specialist (HCS-D or HCS-H), or willing to obtain within 6 months
• Certified OASIS Specialist-Clinical (COS-C), or willing to obtain within 6 months, as applicable
• Certified HOPE Specialist-Clinical (CHS-C), or willing to obtain within 6 months, as applicable
• Good communication skills both written and verbal
• Proven organizational development and project management skills
• Exhibits working knowledge of regulations and reimbursement in home health, hospice, and behavioral health
• Ability to maintain the confidentiality of sensitive financial, clinical, and operational information

You will report to the Manager of Quality Assurance.

This is not a comprehensive list of all job responsibilities; a full job description will be provided.

The base salary for this position is $80,000-$85,000 and is based on the company’s good faith estimate at the time of posting. Actual pay will be determined based on factors such as education, experience, skills, and internal equity.

Equal Employment Opportunity: We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. If you require assistance due to a disability in the application or recruitment process, please submit a request via email at [e-mail].

Pay & Benefit Information: Compensation for this role will be determined based on a variety of factors, including qualifications, skills, competencies, and relevant experience. Elara offers a broad range of benefits. Learn more at https://careers.elara.com/us/en/benefits

EVerify: Elara Caring participates in E-Verify after a job offer is accepted and Form I-9 completed.