Customer Insights Manager, Home Health/Hospice (US, Remote)

Eleos Health, Inc; United States; Remoto; USD 120.000 - 150.000; Tempo pieno

Vantaggi offerti da questo lavoro

Remote‑first culture

Competitive health benefits

Equity opportunity

Professional development stipend

Descrizione del lavoro

Eleos Health, Inc. seeks a Customer Insights Manager to lead HH&H compliance initiatives as we expand into home health and hospice markets.

You’ll translate CMS and payer rules into product requirements, validate AI prompts, and collaborate with product, engineering, and sales to shape compliant care workflows. You will partner with executives and clinicians to close gaps, ensure regulatory alignment, and drive data‑driven improvements across our care‑at‑home platform.

Competenze

• Clinical licensure and direct patient care experience in home health or hospice.
• 5+ years in quality assurance, compliance, or clinical operations leadership within a home health, hospice, or combined HH&H organization.
• Deep working knowledge of CMS Conditions of Participation, OASIS‑E, HOPE, PDGM, and hospice eligibility/recertification documentation standards.
• Hands‑on experience with audit preparation (CMS surveys, state surveys, ADRs, ZPIC/UPIC audits), QAPI programs, and corrective action planning.
• Familiarity with major HH&H EHR systems (e.g., HCHB/Homecare Homebase, WellSky/Kinnser, MatrixCare, Netsmart, Careficient, Healthwyse)
• Strong project management skills, with the ability to prioritize and execute across multiple workstreams simultaneously.
• Experience with LLM prompt engineering, AI model validation, or data‑driven quality improvement methodologies.

Mansioni

• Translate CMS Conditions of Participation, state regulations, accreditation standards, and payer requirements into operational workflows and AI rule sets, maintaining compliance rule libraries.
• Provide clinical validation and SME for AI prompts, Live Quality Assist nudges, and dashboard checks for clinical accuracy and regulatory alignment.
• Lead discovery sessions with HH&H executives, QA/QAPI directors, and clinicians to identify compliance needs and workflow gaps; support implementations end‑to‑end including data schema validation and EHR ingestion.
• Serve as HH&H compliance SME during customer meetings, QBRs, and onsite visits with sales, success, and implementation teams.
• Educate internal teams on HH&H compliance personas, regulatory frameworks, and market dynamics; partner with Product, Clinical Strategy, Engineering, and Sales to reflect HH&H needs in product and GTM.
• Monitor CMS regulations, MAC and payer requirements, translating signals into product and positioning recommendations.

Conoscenze

Clinical licensure & direct patient‑to

Quality assurance leadership

Regulatory knowledge

Audit & QAPI experience

Projects management

AI/LLM prompt experience

Strumenti

HCHB/Homecare Homebase

WellSky/Kinnser

MatrixCare

Netsmart

Careficient

Healthwyse

Descrizione del lavoro

Who is Eleos Health?

Today, more people than ever are speaking publicly about their mental health. Whether it’s ourselves, our friends and family or even public figures, taking care of your behavioral health is no longer a taboo, it’s vital, and it’s only human.

Eleos is on a mission to help deliver the world’s most effective behavioral care through data, measurement, and personalization. Or simply put, we want to give clinicians the support they need to do the important work only they can do.

What is this opportunity?

We are looking for a Customer Insights Manager to join Eleos Health as we expand into the Home Health and Hospice (HH&H) market, working closely with the Clinical Strategy team. You’ll be the HH&H compliance subject matter expert across the company — the bridge between our customers’ clinical realities and our product, engineering, sales, and implementation teams. You’ll translate regulatory frameworks like CMS Conditions of Participation, OASIS-E, HOPE, PDGM, and hospice eligibility standards into actionable product requirements, compliance rulesets, and customer-facing guidance, while helping build the compliance dashboard and custom rules engine for the Care at Home vertical.

Who are you?

You are someone who has lived the frustration of manual, fragmented compliance in home health and hospice and wants to build the technology that actually fixes it. You’ve spent real time delivering direct patient care and have since moved into quality assurance or compliance leadership, so you know both sides of the equation — what clinicians live day to day and what auditors expect on paper. You’re comfortable in ambiguity and energized by cross-functional work, moving fluidly between product conversations, customer discovery calls, and frontline clinical detail. You’re confident enough in your regulatory knowledge to push back when something isn’t right, and you find genuine satisfaction in turning dense CMS language into something an engineer or a salesperson can actually use.

How will you contribute?

• Translate CMS Conditions of Participation, state regulations, accreditation standards, and payer requirements into operational workflows and AI rule sets, and maintain compliance rule libraries covering OASIS-E accuracy, HOPE assessment validation, hospice eligibility/recertification documentation, PDGM coding compliance, and SDoH capture.
• Provide clinical validation and subject matter expertise for AI-driven compliance prompts, Live Quality Assist nudges, and compliance dashboard checks, reviewing AI-generated narrative notes, OASIS responses, and HOPE items for clinical accuracy and regulatory alignment.
• Lead discovery sessions with HH&H executives, QA/QAPI directors, and clinicians to identify compliance needs and workflow gaps, and support compliance implementations end-to-end — including data schema validation, EHR ingestion review, and custom rules development.
• Serve as the HH&H compliance SME during customer meetings, QBRs, and onsite visits alongside sales, customer success, and implementation teams.
• Educate internal teams on HH&H compliance personas, regulatory frameworks, and market dynamics, and partner with Product, Clinical Strategy, Engineering, and Sales Engineering to keep HH&H needs reflected in product and go-to-market materials.
• Monitor changes in CMS regulations, MAC and payer requirements, and accreditation standards, translating market and competitive signals into product and positioning recommendations.

What qualifications and skills will help you be successful?

Required qualifications:

• Clinical licensure and direct patient care experience in home health or hospice (RN, PT, OT, SLP, SW, or equivalent)
• 5+ years in quality assurance, compliance, or clinical operations leadership (director level or above preferred) within a home health, hospice, or combined HH&H organization
• Deep working knowledge of CMS Conditions of Participation, OASIS-E, HOPE, PDGM, and hospice eligibility/recertification documentation standards
• Hands-on experience with audit preparation (CMS surveys, state surveys, ADRs, ZPIC/UPIC audits), QAPI programs, and corrective action planning
• Familiarity with major HH&H EHR systems (e.g., HCHB/Homecare Homebase, WellSky/Kinnser, MatrixCare, Netsmart, Careficient, Healthwyse)
• Strong project management skills, with the ability to prioritize and execute across multiple workstreams simultaneously
• Experience with LLM prompt engineering, AI model validation, or data-driven quality improvement methodologies

Some nice-to-haves:

• Background in revenue cycle management, coding compliance, or billing operations in HH&H
• Certifications such as COS-C, CHC, CPHQ, or HCS-D
• Experience navigating PDGM recoupment risk, hospice fraud enforcement, or CMS TPE reviews

This is a unique opportunity to join a startup that has a meaningful impact on thousands’ well-being and mental health.
This role offers:

• A team of amazing people with a shared vision and the infinite drive to make it happen
• The base pay range for this position is $120,000-150,000 per year. The determination of what a specific employee in this job classification is paid depends on several factors, including, but not limited to, prior employment history/job-related knowledge, qualifications and skills, length of service, and geographic location.
• Opportunity to build, grow, and become highly instrumental in shaping how technology can increase the effectiveness of therapy
• Fully remote work environment

Benefits

For employees

• Competitive health and well-being benefits, mental healthcare support, and life and AD&D insurance
• Significant equity and 401(k) plans matched to 4%
• Company sponsored retirement plan
• Global business travel insurance for you and any dependents traveling with you
• Domestic conference budget and annual learning & development stipend
• Remote work stipend

Life & family

• Generous PTO, additional mental health days, and paid time off to recharge, care for yourself and loved ones, and handle life’s moments
• Fertility treatment and family planning coverage

Culture & development

• Annual learning & development stipend
• Employee resource groups and team-driven celebrations and events