Clinical Quality Specialist – Home Health OASIS & Compliance

Providence at Home with Compassus; Burbank (CA); Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Tuition reimbursement

Competitive pay

Flexible time off

Wellness programs

Job summary

Providence at Home with Compassus is seeking a Clinical Quality Specialist to uphold our care philosophy while ensuring CMS OASIS alignment and thorough documentation across home health assessments. This role emphasizes accuracy, compliance, and patient-centered care, with remote collaboration across teams.

You will drive centralized reviews, verify records, and partner with clinicians and leadership to promote quality improvements, education, and adherence to regulations.

Qualifications

• Associate degree or higher required.
• Bachelor's degree preferred.

Responsibilities

• Completes centralized review of Start of Care, Resumption of Care, Recertification, Significant Change in Condition and Discharge assessments, plans of care and associated workflows.
• Verifies that OASIS responses are supported by the clinical record and consistent with CMS OASIS guidance and item conventions.
• Reviews the plan of care for ordered disciplines and frequencies, documented medical necessity, physician information, medication review, homebound documentation and correspondence with the face-to-face encounter record.
• Queries the assessing clinician when documentation does not support a response and completes final review and lock of the assessment following resolution.
• Completes utilization review activities including visit utilization, LUPA risk, recertification appropriateness and hospitalization risk, and documents recommendations for agency action.

Education

Associate degree

Bachelor's degree

Job description

Providence at Home with Compassus is seeking a Clinical Quality Specialist to uphold our care philosophy while ensuring CMS OASIS alignment and thorough documentation across home health assessments. This role emphasizes accuracy, compliance, and patient-centered care, with remote collaboration across teams.

You will drive centralized reviews, verify records, and partner with clinicians and leadership to promote quality improvements, education, and adherence to regulations.