Clinical QA Specialist

ABOUT FLOURNOY HEALTH SYSTEMS:

Flournoy Health Systems (FHS) specializes in healthcare management, supporting organizations that deliver services for seniors, chronically ill patients, and individuals requiring home and hospice care. We are committed to high standards of excellence, compassion, and compliance in all our services. FHS encompasses multiple subsidiaries, including Primecare Home Care Services (GA and IN), Primecare Hospice, Primecare ABA Therapy, Justcares Home Care, Wellness Track 360, and Primecare Real Estate.

OUR CORE VALUES:

Compassionate Care: We are dedicated to delivering care with empathy, understanding, and respect. Our commitment to compassionate care ensures that every individual receives the attention and support they deserve, enhancing their well-being and dignity.

Accessibility & Equity: We believe in making healthcare accessible to everyone, regardless of their background or circumstances. We strive to eliminate barriers to care and provide equitable care that meets the diverse needs of the communities we serve.

Innovation & Excellence: We strive to stay at the forefront of healthcare by embracing new ideas and approaches. Our pursuit of excellence ensures that we consistently provide the best possible care and continuously improve our services.

Integrity & Accountability: We operate with honesty, transparency, and a deep sense of responsibility. Our commitment to integrity and accountability ensures that we always act in the best interests of our clients, our team, and our communities.

Collaboration & Community: We understand that our strength lies in working together. Through collaboration with our partners and engagement with the communities we serve, we build strong, supportive networks that uplift everyone involved.

Position Summary:

Flournoy Health Systems (FHS) is seeking an experienced Clinical QA Specialist who ensures the accuracy, completeness, and compliance of clinical documentation and care delivery practices across FHS service lines. This role is responsible for maintaining quality standards aligned with CMS, CHAP/ACHC, state requirements, and internal SOPs. The Clinical QA Specialist manages incident reporting, supports corrective action plans, and coordinates clinical audits to ensure continuous compliance and readiness for surveys and regulatory inspections.

• Oversee and update the Clinical Quality Management system, ensuring alignment with CMS, CHAP, and FHS standards.
• Assist in the creation and review of clinical SOPs, policies, controlled documents, and templates (e.g., care plans, assessments, forms).
• Ensure staff adherence to SOPs and compliance with standards of care and regulatory requirements.
• Lead the incident management process by tracking and addressing complaints, deviations, and non-compliance issues.
• Oversee Corrective and Preventive Action (CAPA) activities, ensuring timely closure and follow-up.
• Provide training and feedback to staff related to incident and CAPA outcomes.
• Organize, coordinate, and execute audits of clinical documentation, internal teams, vendors/partners, and care delivery processes.
• Conduct focused chart reviews of care plans, supervisory visits, OASIS, IDG documentation, and interdisciplinary notes.
• Prepare audit documentation, including audit plans, reports, certificates, and CAPA tracking.
• Review and finalize audit reports, ensuring accuracy and completeness.
• Support CHAP/ACHC survey readiness by conducting mock surveys and record reviews.
• Verify compliance with physician orders, visit frequencies, interdisciplinary team documentation, and client care coordination.
• Collaborate with the Compliance Manager and Clinical Leadership to implement corrective actions from audits or survey findings.
• Examine and validate clinical records, including care plans, orders, consents, medication logs, and discharge summaries, for compliance and completeness.
• Monitor adherence to best practices for patient safety, documentation, and care transitions.
• Ensure timely and accurate updates to client records in EMR systems.

• Bachelor's degree in Nursing (BSN) or healthcare-related field required; RN license preferred.
• 3–5 years clinical experience in home health, hospice, or post-acute care.
• Experience in clinical quality assurance, auditing, or accreditation preparation.
• Strong knowledge of CMS Conditions of Participation, CHAP/ACHC standards, and payer documentation requirements.
• Excellent analytical, documentation review, and training skills.
• Strong ability to manage incident reporting and corrective action workflows.
• Experience monitoring contract and regulatory compliance (Medicaid, Medicare, or state health programs).
• Experience in home care, hospice, managed care, or provider settings preferred.
• Strong knowledge of CMS Conditions of Participation, CHAP/ACHC standards, HIPAA, and payer compliance requirements.
• Ability to assess risks, identify gaps, and recommend solutions.
• Detail-oriented with a systematic approach to audits.