Clinical Quality Assurance Specialist, RN

About Wider Circle

Wider Circle is a purpose-led healthcare organization focused on improving outcomes for older adults and people with complex health needs. The company works to remove the social and clinical obstacles that can interfere with quality care, partnering with health plans and local organizations so members can navigate the healthcare system, stay involved in their care, and live healthier lives.

The company is building a permanent clinical program that brings together physicians, care advocates, and community support teams to deliver coordinated, person-centered care. This role is for an operations-oriented RN who will help ensure every patient encounter is documented accurately, can stand up to review, is billable, and supports better patient outcomes.

About the Role

Wider Circle is seeking a Quality Assurance Specialist, RN, to design, launch, and manage the clinical quality assurance function. This is a highly hands-on operational role rather than a simple review checklist position. The work includes chart review, QA scheduling, and making sure documentation is clear, thorough, and supported across the care team.

You will report to the Senior Director of Clinical Operations and collaborate closely with Operations, Billing, and the Training and Enablement Specialist. The goal is to turn QA observations into real improvements by identifying trends, addressing root causes, and implementing corrective action plans.

Core Responsibilities

• Review clinical records on a recurring schedule for both newly hired and existing team members, including random sampling, monthly QA tracking, and audit documentation.
• Confirm that documentation and billing meet compliance standards, with each patient encounter supported by appropriate clinical reasoning, and partner with Billing to resolve ambiguous cases.
• Escalate broader themes, gaps, and risks to leadership, along with practical recommendations and support for adapting to updated standards.
• Work cross-functionally to act on QA findings by helping Operations improve workflows and automation, supporting Billing on revenue and documentation issues, and partnering with Training and Enablement on targeted skill-building.
• Create a clinical quality scoring model with clear criteria for coaching and escalation, and incorporate these scores into performance reviews so they reflect care quality as well as productivity.
• Own and expand the QA program, including tracking, scoring frameworks, adverse event reporting, grievance management, and support for health plan audits.
• Maintain a clear boundary between clinical QA and billing QA while managing the transition between the two processes.

Why This Role Matters

Strong documentation is not just administrative work. It affects whether a visit is billable or becomes a loss, whether an audit is passed or failed, and whether a care plan is reliable. Just as importantly, accurate documentation gives providers a clearer view of each patient, improving the quality of care. In this role, you will help establish the standard for clinical quality as Wider Circle grows.

Requirements

• An active, unrestricted RN, NP, LPN, or LCSW license; multi-state or compact licensure is preferred.
• At least 3 years of clinical experience, plus background in operations or quality, ideally within a healthcare organization or fast-growing healthcare startup.
• Practical experience reviewing charts for billing compliance and understanding what strong, defensible clinical notes look like.
• Solid knowledge of documentation requirements for Medicare, Medicaid, and value-based care; familiarity with community health billing such as CHI/PIN and CHW services is an advantage.
• An operations-first approach that focuses not only on identifying issues but on building systems, schedules, trackers, scoring tools, and automation to prevent recurrence.
• Comfort using technology and a forward-looking mindset toward automation and AI in quality operations, with the ability to learn new tools quickly.
• Receptiveness to feedback and the ability to give direct, constructive feedback in return.
• A proactive, persistent approach to problem-solving and follow-through.
• Comfort working in a fast-moving and sometimes uncertain environment.
• Strong project management, prioritization, and attention-to-detail skills.
• Ability to analyze data independently by pulling, organizing, and interpreting QA information.
• Strong collaboration skills across Operations, Billing, Training, and frontline teams.
• Familiarity with EHR systems, Slack, Google Suite, and QA or audit tools.

Compensation & Benefits

The base salary range for this position is $80,000 to $95,000. Final compensation will depend on qualifications, experience, skills, and location. This position is also eligible for Wider Circle’s full benefits package.

As a venture-backed employer, Wider Circle offers a competitive package that includes medical, dental, and vision coverage; a 401(k) plan; paid time off; an employee assistance program; health care FSA; dependent care FSA; HSA; voluntary disability coverage; basic life and AD&D insurance; adoption assistance; and training and development.