QAPI & Clinical Review Clinician (RN/PT)
The Family Home Health Network
A partner of the Alden Network, Family Home Health Network is a leading post-acute care provider delivering Home Health, Hospice, Palliative Care, and Skilled/Private Duty services throughout the Chicagoland area. We are committed to providing exceptional patient-centered care while maintaining the highest standards of clinical excellence, compliance, and regulatory readiness.
Position Summary
The QAPI & Clinical Review Clinician (RN/PT) is responsible for supporting and maintaining the agency's Quality Assurance and Performance Improvement (QAPI) program across Home Health and Hospice services. This role combines quality management, clinical auditing, regulatory compliance, and hands-on review of clinical documentation to ensure the delivery of high-quality patient care.
A significant focus of this position includes the review and oversight of Nursing and Therapy Start of Care (SOC) documentation, DFS assessments, OASIS documentation, and discharge records to ensure accuracy, completeness, timeliness, and regulatory compliance. The QAPI & Clinical Review Clinician serves as a key resource for clinical quality, documentation integrity, regulatory readiness, and performance improvement initiatives while collaborating closely with clinicians, therapists, and agency leadership.
Key Responsibilities
Regulatory Compliance
Ensure compliance with CMS Conditions of Participation for Home Health.
Maintain readiness for state surveys, accreditation reviews, and regulatory audits.
Monitor adherence to agency policies, clinical standards, and documentation requirements.
Interpret and communicate regulatory updates to clinical and administrative staff.
Assist leadership in developing and implementing quality improvement initiatives supporting regulatory compliance and clinical excellence.
Participate in agency survey preparation activities and corrective action planning.
Clinical Quality, SOC, DFS & Discharge Oversight
Review Nursing and Therapy Start of Care (SOC) documentation for accuracy, completeness, timeliness, and compliance with regulatory standards.
Conduct quality reviews of DFS assessments and related documentation.
Audit OASIS documentation to ensure assessment accuracy, documentation integrity, and consistency with clinical records.
Review discharge documentation to ensure appropriate care coordination, patient outcome reporting, and record completion.
Monitor timeliness and accuracy of SOCs, DFS assessments, OASIS records, transfers, recertifications, and discharges.
Identify trends, risks, documentation deficiencies, and opportunities for clinical improvement.
Collaborate with nurses, therapists, clinical managers, and leadership to resolve documentation issues.
Provide feedback and education to clinicians regarding documentation quality, compliance requirements, and best practices.
Assist in developing corrective action plans related to quality, documentation, and compliance findings.
Serve as primary or backup resource for OASIS and HOPE submission activities to CMS, including file transmission, validation report review, error correction, data reconciliation, and ongoing monitoring of compliance with CMS submission timelines and quality reporting requirements.
Clinical Auditing & Documentation Review
Conduct routine and focused clinical chart audits.
Evaluate compliance with agency policies, CMS regulations, OASIS guidance, and payer requirements.
Identify documentation trends that impact quality outcomes, reimbursement, survey readiness, and regulatory compliance.
Track audit findings and monitor corrective actions to completion.
Participate in investigations and reviews related to incidents, complaints, adverse events, and quality indicators.
Support documentation improvement initiatives across all clinical disciplines.
Data Analysis & Reporting
Collect, analyze, and report agency quality data including:
OASIS outcome measures
CAHPS scores
SOC timeliness
DFS completion and outcomes
Discharge outcomes
Hospitalization and rehospitalization rates
Star Ratings
Infection prevention and patient safety metrics
Other agency quality indicators
Additional responsibilities include:
Utilize dashboards and quality reporting tools to monitor agency performance.
Identify trends and opportunities for performance improvement.
Prepare reports and present findings to agency leadership, committees, and governing bodies.
Support organizational performance improvement projects and strategic initiatives.
Education & Performance Improvement
Educate and mentor clinicians on documentation standards, OASIS accuracy, SOC requirements, DFS expectations, and discharge documentation.
Participate in QAPI committees and interdisciplinary quality improvement activities.
Assist in the development and revision of clinical policies, procedures, and workflows.
Promote a culture of continuous quality improvement, patient safety, and accountability.
Support orientation, onboarding, and ongoing competency development of clinical staff.
Serve as a resource for quality management, documentation compliance, and best clinical practices.
Qualifications
Education & Licensure
Current, unrestricted Registered Nurse (RN) or Physical Therapist (PT) license in the state of practice.
Bachelor's degree in Nursing, Physical Therapy, or related healthcare field required.
Experience
Minimum of 3-5 years of Home Health and/or Hospice clinical experience.
Previous experience in Quality Assurance, Performance Improvement, Clinical Review, Documentation Auditing, or Regulatory Compliance preferred.
Experience with Homecare Homebase (HCHB) strongly preferred.
Experience reviewing OASIS, SOC, DFS, transfer, recertification, and discharge documentation preferred.
Experience participating in survey preparation and regulatory readiness activities preferred.
Knowledge, Skills & Abilities
Strong knowledge of QAPI principles and performance improvement methodologies.
Thorough understanding of CMS Home Health and Hospice Conditions of Participation.
Knowledge of OASIS guidance and documentation requirements.
Strong understanding of Nursing and Therapy Start of Care processes.
Ability to conduct detailed clinical record reviews and documentation audits.
Strong analytical skills with the ability to interpret quality data and identify trends.
Excellent organizational, communication, coaching, and leadership skills.
Ability to manage multiple priorities in a fast-paced healthcare environment.
Strong critical-thinking, problem-solving, and decision-making abilities.
Commitment to clinical excellence, compliance, and positive patient outcomes.
Benefits:
401(k)
Dental insurance
Health insurance
Life insurance
Pet Insurance
Mileage reimbursement
Paid orientation
Paid time off
Tuition reimbursement
Vision insurance
