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Become a part of our caring community and help us put health first

The Home Health Quality Auditor ensures clinical documentation meets CMS regulations, OASIS accuracy, and Medicare Conditions of Participation. This role audits Start of Care, Recertification, and Discharge records for compliance, accuracy, and completeness, helping reduce audit risk and billing delays. The auditor monitors QA metrics, identifies trends, and collaborates with leadership to improve workflows, support Kinnser EMR transition, and drive continuous quality improvement.

Use your skills to make an impact

Responsibilities

+ Audit Start of Care (SOC), Recertification, and Discharge documentation for completeness, accuracy, and compliance with CMS and payer requirements.

+ Verify coding accuracy, medication reconciliation, and alignment of the plan of care with clinical documentation.

+ Perform timely QA reviews to minimize billing delays and improve operational KPIs.

+ Monitor QA dashboard metrics and provide actionable feedback to clinicians and leadership.

+ Identify documentation trends and collaborate with leadership to develop targeted training and job aids.

+ Ensure documentation workflows align with **Kinnser EMR** protocols during system transition.

+ Conduct root cause analyses on recurring documentation errors and recommend corrective actions.

+ Maintain audit tools, policies, and procedures to ensure consistency and inter-rater reliability.

+ Present audit findings and performance trends to senior leadership and quality committees.

+ Support continuous quality improvement initiatives to enhance compliance and patient safety.

Qualifications

+ Active RN license required; BSN or bachelor’s in health-related field preferred.

+ Minimum 4 years of healthcare quality experience, with strong knowledge of CMS Home Health regulations and Medicare Conditions of Participation.

+ Familiarity with OASIS requirements and home health documentation standards.

+ Experience with EMR systems (Kinnser preferred).

+ Proficient in Microsoft Office (Word, Excel) and data analysis tools.

+ Strong communication skills with proven ability to provide education and present findings to leadership.

+ Ability to work independently and manage multiple priorities effectively.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$53,700 - $72,600 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients’ homes. OneHome’s patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.

About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.