Registered Nurse, Quality Assurance — In-Home Clinical Services

Registered Nurse, Quality Assurance — In-Home Clinical Services

Position Summary

The Registered Nurse, Quality Assurance is responsible for driving the clinical quality and consistency of practitioners who perform in-home assessments, laboratory tests, and diagnostic services across the member's home or any alternate location where services are delivered. This role combines clinical oversight, data-driven performance analysis, and direct coaching to ensure every encounter meets evidence-based standards, regulatory requirements, and the organization's quality benchmarks. The RN Quality Assurance partner serves as both an auditor and an educator — translating quality data into actionable feedback that elevates practitioner performance and improves member outcomes.

Key Responsibilities

Quality Oversight & Auditing

• Conduct routine and targeted audits of in-home assessments, lab specimen collection, and diagnostic procedures performed by field practitioners (NPs, RNsand LPNs

• Review documentation, chart notes, and encounter data for completeness, clinical accuracy, and adherence to protocols.

• Perform ride-along and virtual observation visits to assess clinical technique, member interaction, infection control, and specimen handling.

• Identify deviations from clinical standards and document findings in the quality management system.

Data Analysis & Reporting

• Analyze quality metrics, audit results, lab rejection rates, redraw rates, and member-experience data to identify trends and root causes.

• Build and maintain dashboards and reports that surface practitioner-level and program-level performance to operations and clinical leadership.

• Translate quantitative findings into prioritized improvement opportunities with measurable targets.

• Partner with data and analytics teams to refine quality measures and benchmarks over time.

Coaching, Education & Practitioner Development

• Deliver one-on-one feedback and coaching to practitioners based on audit findings, with clear expectations and follow-up.

• Design and assist in training sessions, in-services, and competency assessments covering clinical procedures, documentation, and member experience.

• Develop job aids, SOPs, and reference materials that codify best practices for in-home and alternate-site service delivery.

• Mentor new hires through onboarding and validate clinical competency before independent practice.

Compliance & Continuous Improvement

• Ensure practitioner activities comply with CLIA, OSHA, HIPAA, state nursing scope-of-practice rules.

• Investigate clinical incidents, near misses, and member complaints; document findings and recommend corrective action.

• Collaborate with Operations to close gaps and operationalize new clinical workflows.

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in the state of residence; willingness to obtain additional state licensure or compact privileges as required.

• Bachelor of Science in Nursing (BSN) required; advanced degree (MSN, MPH, or MHA) preferred.

• Minimum 5 years of clinical nursing experience, with at least 2 years in quality assurance, clinical auditing, case management, or a comparable oversight role.

• Experience with in-home care, mobile health, home health, or community-based clinical services strongly preferred.

• Working knowledge of laboratory specimen collection, point-of-care testing, and common in-home diagnostic procedures.

• Familiarity with CLIA, OSHA, HIPAA, and applicable state and federal regulations governing clinical practice.

Skills & Competencies

• Analytical mindset — comfortable working with audit data, performance metrics, and Excel or Tableau tools to identify patterns and prioritize action.

• Strong written and verbal communication skills, with the ability to deliver direct, constructive feedback to clinicians at all levels.

• Sound clinical judgment and meticulous attention to detail in reviewing documentation and observing procedures.

• Coaching and adult-learning skills; able to teach without alienating.

• Proficiency with electronic health records, quality management platforms, and Microsoft Office (Excel, Word, PowerPoint).

• Ability to work independently, manage a multi-state caseload, and prioritize across competing audits and projects.

Working Conditions

• Hybrid role with a mix of remote chart review, virtual coaching, and field-based observation visits.

• Travel up to 50–60% (or as determined by the business) to member homes, partner sites, or other service locations for ride-alongs and audits.

• Occasional evening or weekend availability to observe practitioners working non-standard shifts.

• Must maintain a valid driver's license, reliable transportation, and current auto insurance.