Currently observed
Clinical QA Nurse (RN)
Claim Health · New York City
Apply at employer source ↗Save to a private candidate tracker →Role description
About the RoleWe're hiring a Registered Nurse with deep home health and hospice experience to own the clinical quality of the documentation flowing through our AI platform.Our automations review referrals, OASIS documentation, certifications, physician orders, hospice election forms, face-to-face documentation, and supporting clinical records before they reach billing and authorization workflows. Your job is to ensure those automations make clinically sound decisions, identify where they fail, and continuously improve their accuracy.You'll work at the intersection of clinical expertise, quality assurance, and AI. Rather than reviewing a handful of patient charts each day, you'll help build systems that review thousands correctly.This is not a bedside or utilization review position. It's an operations and quality role for a nurse who enjoys finding edge cases, improving processes, and translating clinical judgment into scalable automation.What You'll DoAudit clinical QA performanceReview charts processed by our clinical automation platform for accuracy, completeness, and consistency. Validate whether documentation supports services, identify incorrect classifications, and investigate why automation errors occurred.Improve clinical automation logicPartner with engineering and product teams to refine how our AI evaluates clinical documentation. You'll identify where automations miss important clinical nuances, recommend decision rules, and validate improvements before they're deployed.Build clinical review standardsDevelop SOPs that define how clinical documentation should be reviewed across home health and hospice. Standardize quality expectations while accounting for agency-specific workflows and payer requirements.Support customer implementationsWork directly with agencies to understand their documentation standards, clinical workflows, and compliance expectations. Help configure automations that align with each client's operational processes.Drive quality metricsMeasure and improve documentation quality, automation accuracy, exception rates, clinical escalations, and rework. Continuously identify opportunities to improve automation performance.What We're Looking ForRequiredActive RN license (NY or compact license preferred)3+ years of home health and/or hospice clinical experienceStrong understanding of OASIS documentation and home health eligibility requirementsExperience reviewing physician orders, certifications, plans of care, face-to-face documentation, and hospice election paperworkHands-on experience with HomeCare HomeBase (HCHB), Axxess, and WellSky; KanTime a plusStrong understanding of Medicare home health and hospice documentation requirementsExperience writing SOPs, QA guidelines, or training documentationExcellent attention to detail and pattern recognitionComfortable working in a fast-paced startup environmentNice to HaveQA, Clinical Documentation Integrity (CDI), or Compliance experienceExperience with AI, workflow automation, or healthcare technology companiesFamiliarity with referral platforms including Careport and ForcuraExperience implementing or optimizing EMR workflowsWhy This RoleScale your clinical expertise. Help AI review thousands of charts instead of reviewing them one at a time.Own quality. Your feedback directly improves the clinical accuracy of our platform across every customer.Influence the product. Work side-by-side with engineering to shape how AI understands home health and hospice documentation.