RN Quality Assurance Reviewer

RN Quality Assurance Reviewer

Essential HealthCare Solutions (EHS) is dedicated to addressing complex healthcare challenges through innovative solutions. With a strong leadership team and a focus on quality service delivery, we provide comprehensive healthcare support across various verticals, including medical staffing, compliance, provider network development, and behavioral health program development.

Summary

As a member of the Essential HealthCare Solutions team, you will be instrumental in delivering high-quality healthcare services. This role is essential to ensuring excellence in patient care and supporting our mission to create safer and healthier communities. We are seeking a goal-oriented problem-solver and team player who is ready for the responsibility required to work in a professionally stimulating environment. This role ensures quality of care for patients and residents in healthcare facilities nationwide while sharing knowledge and expertise to support the company's mission of providing superior customer service.

You will enjoy

• Flexible paid vacation days
• Paid holidays
• Company-issued and company-paid Amex card for travel
• All travel expenses paid directly by the company
• Airline and hotel points accumulate for the employee's personal use
• Health insurance
• Dental insurance
• Vision insurance
• Life insurance
• Disability insurance
• Extensive training opportunities
• Predictable work schedule

Responsibilities

• This position is 100% remote with up to 75% travel. The Quality Assurance/Compliance Medical Facility Surveyor will serve as a team member or leader on various types of surveys, including:
• Long-Term Care (LTC) and Non-Long-Term Care Surveys (re-certification, comparative, complaint investigation, and revisits).

The surveyor will travel nationwide to healthcare facilities, assessing compliance with federal and state regulations governing the quality of care for residents. The role requires applying approved survey protocols during evaluations. Specific duties include:

• Conducting surveys of Medicare-Medicaid certified healthcare facilities to ensure compliance with federal regulations.
• Preparing for surveys through off-site preparation, touring the facility, observing care, reviewing records, and interviewing staff and residents.
• Evaluating quality of care, consumer rights, clinical documentation, physical plant requirements, and overall facility operations.
• Communicating non-compliance findings to key facility personnel throughout the survey process, including during the exit conference.
• Determining if corrective action plans are acceptable and ensuring implementation.
• Conducting follow-up visits and monitoring surveys to verify compliance.
• Assisting with facility and bureau training as needed.
• Participating in workgroups for ongoing process improvements.

Qualifications

• Associate's or Bachelor’s degree in a clinical or related discipline.
• Completion of CMS Long-Term Care Basic Training and successful completion of the Surveyor Minimum Qualifications Test (SMQT) preferred.
• At least two (2) years of experience as a surveyor accrediting or certifying facilities serving long-term care residents.
• Experience in Quality Measures (QM) derived from the Resident Assessment Instrument (RAI) / Minimum Data Set (MDS).
• Active clinical licensure (e.g., RD, LCSW) is highly desirable.
• Federal survey protocols, including the ability to assess Nursing Homes, Domiciliary, and Adult Day Health Care Programs.
• Ability to review, score, and document compliance using survey forms, including Nursing Home Survey Reports, Domiciliary Survey Reports, and Adult Day Health Care Survey Reports.
• Ability to set priorities independently and work effectively within a team setting.
• Strong conflict-resolution skills and the ability to escalate concerns appropriately.
• Willingness to travel up to 75% of the time regularly.

Experience Required

• Previous CMS or state survey experience conducting nursing home inspections.
• Knowledge of long-term care facility operations and regulations.
• Experience with Medicare-Medicaid compliance reviews.
• Facilities covered: Nursing homes, ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD) centers, Psychiatric Residential Treatment Facilities (PRTF), hospitals, critical access hospitals, and hospice facilities.

Salary Commensurate with experience

Essential HealthCare Solutions is an Equal Opportunity Employer

We are an Equal Employment/Affirmative Action employer. We do not discriminate in hiring based on sex, gender identity, sexual orientation, race, color, religious creed, national origin, physical or mental disability, protected Veteran status, or any other characteristic protected by federal, state, or local law. If you need reasonable accommodation for any part of the employment process, please contact Human Resources and let us know the nature of your request and your contact information.

Accommodation requests will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to by Human Resources.