Clinical QA Nurse (Registered Nurse)

About the Role

We are seeking a Registered Nurse with substantial experience in home health and hospice care to oversee the clinical quality within our AI-driven documentation platform. This role focuses on ensuring the clinical soundness and accuracy of automated reviews applied to referrals, OASIS documentation, certifications, physician orders, hospice election forms, face-to-face documentation, and supporting clinical records prior to billing and authorization stages.

You will be positioned at the nexus of clinical expertise, quality assurance, and artificial intelligence. Instead of manually reviewing a limited number of patient charts daily, you will contribute to the development and enhancement of systems capable of accurately processing thousands simultaneously.

This position does not involve bedside patient care or utilization review. It is an operational and quality-focused nursing role aimed at identifying exceptions, refining processes, and translating clinical judgments into scalable automation solutions.

Key Responsibilities

• Audit clinical QA performance by reviewing charts processed through the clinical automation platform to verify accuracy, completeness, and consistency of documentation, ensuring service support, detecting misclassifications, and diagnosing causes of automation errors.
• Collaborate with engineering and product development teams to enhance AI evaluation criteria of clinical documentation by pinpointing gaps in automation and recommending clinical decision rules, as well as validating updates prior to rollout.
• Develop and maintain Standard Operating Procedures (SOPs) that standardize clinical documentation review processes across home health and hospice, incorporating agency-specific workflows and payer requirements.
• Engage with client agencies to understand their clinical workflows, documentation protocols, and compliance standards, aiding configuration of automation that aligns with their operational practices.
• Track and improve key quality indicators such as documentation quality, automation precision, exception rates, clinical escalations, and rework, identifying and implementing enhancements continuously.

Qualifications and Experience

• Active Registered Nurse license, preferably NY state or a compact license.
• Minimum of 3 years clinical experience in home health and/or hospice settings.
• In-depth knowledge of OASIS documentation standards and home health eligibility criteria.
• Experience evaluating physician orders, certifications, care plans, face-to-face documentation, and hospice election paperwork.
• Proficiency with healthcare software platforms including HomeCare HomeBase (HCHB), Axxess, WellSky; familiarity with KanTime is advantageous.
• Strong understanding of Medicare documentation requirements for home health and hospice services.
• Demonstrated ability in creating SOPs, QA guidelines, or training materials.
• Exceptional attention to detail with strong pattern recognition capabilities.
• Adaptability to work efficiently within a dynamic, fast-moving startup environment.

Preferred Skills

• Background in Quality Assurance, Clinical Documentation Integrity (CDI), or Compliance.
• Experience working with AI, workflow automation, or within healthcare technology firms.
• Knowledge of referral platforms such as Careport and Forcura.
• Experience in optimizing or implementing Electronic Medical Record (EMR) workflows.

Why Join Us

• Amplify your clinical impact by enabling AI to analyze thousands of charts instead of one at a time.
• Take ownership of clinical quality, with your input directly enhancing platform accuracy across clients.
• Collaborate closely with engineering teams to influence how AI interprets home health and hospice documentation.