Home Health Quality Assurance Manager

Job not on LinkedIn

November 15

🐊 Florida – Remote

Although this job is listed in Florida, this company may be open to hiring remote in other states.

💵 $104k - $143k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

🦅 H1B Visa Sponsor

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Humana

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Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

📋 Description

• Develop, implement, and maintain a comprehensive QAPI program focused on clinical excellence, patient safety, and regulatory compliance. • Ensure adherence to all applicable regulations, accreditation standards, and payer requirements for home health services. • Design and oversee audits of clinical documentation, care delivery, and patient outcomes; analyze findings to identify trends and improvement opportunities. • Utilize data analysis, gap assessments, and root cause analysis to inform corrective actions and process enhancements. • Partner with interdisciplinary teams to implement clinical and operational improvements that enhance patient care and efficiency. • Present audit results, performance trends, and improvement outcomes to senior leadership and quality committees. • Create and maintain quality policies, procedures, and tools, including audit instruments and inter-rater reliability methodologies. • Establish key quality indicators, set benchmarks, and track progress toward goals. • Lead efforts to obtain and maintain home health-specific accreditations and certifications. • Support staff training on clinical operations, regulatory standards, and quality programs.

🎯 Requirements

• Active clinical license (RN, PT, OT, or equivalent) required • Bachelor’s degree in healthcare or related field required; Master’s preferred • CPHQ certification preferred; Lean Six Sigma a plus • Strong knowledge of CMS Conditions of Participation and Medicare Advantage regulations • Minimum 5 years of healthcare quality experience, including 2 years in a leadership role • Proven ability to lead accreditation efforts in a home health setting preferred • Expertise in continuous quality improvement methodologies, data analysis, and process redesign • Excellent communication and presentation skills for senior leadership engagement.

🏖️ Benefits

• medical, dental and vision benefits • 401(k) retirement savings plan • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) • short-term and long-term disability • life insurance and many other opportunities