RN or LVN Quality Assurance In House

Spirit Home Health is looking for a full-time RN or LVN QA specialist to work in our office near LAX. This is not a remote or hybrid position. Must have experience in home health and in QA or Case Management. Job Summary The QA Specialist in Home Health is responsible for ensuring clinical documentation and patient care meet all regulatory, payer, and internal quality standards. This role plays a key part in compliance with Medicare Conditions of Participation, optimizing outcomes, and maintaining accreditation readiness. Duties • Review completed assessments, H&P, RN assessment reports. Complete coding, QA, and plan of care accordingly. Identify inconsistencies with documentation and coordinate with vising nurse on clarification requests. Request further documentation as needed (i.e. photos, orders, flow sheets, etc.). • Review Start of Care documentation, medication lists and identify errors and inconsistencies. • Complete QA audit based on audit tool checklist provided. • Review patient clinical records (e.g., SOC/ROC/Recert/Discharge notes, OASIS, Plan of Care) to ensure accuracy, completeness, and compliance with Medicare guidelines (e.g., Chapter 7 of the Medicare Benefit Policy Manual). • Identify and flag documentation that lacks skilled need, medical necessity, or proper supporting evidence. • Conduct routine internal audits of nursing, therapy, and aide documentation. • Monitor timeliness and consistency of visit documentation, orders, and supervisory visits. • Track infections, falls, incidents and change of conditions and ensure that proper documentation/orders are completed accordingly. • Assist in preparing and responding to ADRs, TPEs, and other audits or payer requests. • Provide feedback on common documentation trends and coordinate with QAPI board on actions necessary to mitigate the issues moving forward • Ensure OASIS assessments are accurate and consistent with visit notes and plan of care. • Stay up to date on CMS regulations, state licensure rules, and payer-specific requirements. Experience • Licensed Registered Nurse (RN) or Licensed Vocational Nurse (LVN). • 2–5 years of experience in home health quality assurance, clinical documentation review, or utilization review. • Strong knowledge of Medicare Conditions of Participation, OASIS, and HIPAA. • Experience with EMR systems commonly used in home health (e.g., Healthcare Synergy, DSL, Axxess, Kinser). • Excellent analytical, communication, and training skills. Additional qualifications: • Detail-oriented with strong clinical judgment. • Able to communicate effectively with clinicians, office staff, and leadership. • Proactive in identifying compliance risks and proposing corrective actions. • Comfortable working independently and meeting deadlines. Job Type: Full-time Pay: Up to $40.00 per hour Expected hours: 40 per week Benefits: • 401(k) • Dental insurance • Health insurance • Paid time off • Vision insurance Experience: • home health: 1 year (Required) • EMR systems: 1 year (Required) • Quality assurance: 1 year (Required) License/Certification: • nursing license in California (Required) Ability to Commute: • Los Angeles, CA 90045 (Required) Work Location: In person