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Integrated Home Care Services, Inc. · 16 hours ago

QA Training Specialist

United States

Full-time

Remote

Mid Level

3+ years exp

Integrated Home Care Services, Inc. provides an Integrated Delivery System in the home setting, focusing on high-quality in-home care services. The Quality Assurance & Training Specialist is responsible for driving documentation excellence and ensuring compliance through auditing and targeted education.

Health CareHospitalityProfessional Services

Responsibilities

Drives documentation excellence across Care Management and Utilization Management (UM) by auditing case records, identifying knowledge gaps, and delivering targeted education

Becomes the subject matter expert (SME) in all documentation types reviewed (e.g., UM determinations, NOMNC notices, care coordination notes)

Ensuring compliance with internal policies, NCQA standards, CMS/ODAG regulatory requirements, and payer-specific guidelines

Partners with leaders and frontline teams to improve accuracy, timeliness, and completeness of documentation

Measurably raising performance and closing gaps

Qualification

Quality AssuranceClinical Documentation ReviewNCQA Standards KnowledgeExcel/Power BI ProficiencyTraining DesignDeliveryProcess Improvement CertificationAnalytical SkillsCoaching SkillsChange ManagementHome Health CoordinationDocumentation Systems ExperienceCommunication

Required

Bachelor's degree in nursing, Health Administration, Public Health, or related field (Active RN license REQUIRED)

3+ years in Quality Assurance, UM/CM auditing, health plan/provider operations, or clinical documentation review

Working knowledge of NCQA UM standards, CMS/ODAG (including NOMNC), HIPAA, and payer documentation requirements

Demonstrated experience designing and delivering training based on audit findings (adult learning principles, competency-based education)

Strong analytical skills with proficiency in Excel/Power BI; ability to turn data into actionable insights

Excellent written/verbal communication; skilled in coaching and change management

Experience with home health coordination, durable medical equipment coordination, care transitions, or UM decision/notification workflows

Preferred

Prior IRR program or calibration experience for auditors/reviewers

Process improvement certifications (e.g., Lean Six Sigma Yellow/Green Belt)

Experience with documentation systems (e.g., EMR/EHR, case management platforms) and SharePoint/Teams collaboration

Benefits

Medical, Vision, Dental, Short- and Long-term insurance

6+ Days of Holidays Pay

15+ days of PTO

Employer paid life insurance

401K with employer contribution

Wellness program with reward incentives

Employee recognition and reward programs

Company

Integrated Home Care Services, Inc.

Integrated Home Care Services (IHCS) delivers value-based home care solutions that help patients, providers, and health plans achieve their care goals in the home.

Founded in 2015

Miami Beach, Florida, USA

501-1000 employees