[Hiring] Clinical Quality Manager @Adaptive Home Health / Fira Health

Role Description

The Clinical Quality Manager is a centralized, remote RN role that provides clinical backbone support to the field clinical team. This is not a field position — the Clinical Quality Manager operates from a central hub to ensure that orders, EMR workflows, back-office clinical functions, and regulatory and billing compliance tasks are completed with accuracy and timeliness.

The Clinical Quality Manager brings the knowledge and expertise of a registered nurse to back-office functions that require clinical oversight. This role is purpose-built to take high-volume, process-intensive clinical tasks off the branch Clinical Manager's plate so that the branch Clinical Manager can focus on direct clinical oversight, coaching, and rehospitalization prevention in the field. This is NOT a passive support role.

The Clinical Quality Manager is accountable for timely, accurate clinical decision-making within the EMR. You will own workflows that directly affect patient safety, billing integrity, and regulatory compliance.

What You'll Do

• Drive quality, safety, and compliance through systems
• Identify recurring clinical and documentation issues and implement process improvements
• Support quality assurance activities by ensuring clinical work meets standards before downstream review
• Order management & EMR workflow execution
• Review and approve new orders in EMR; ensuring:
  • compliance with documentation standards for verbal orders
  • orders are complete and address patient care needs
• Complete clinical escalation reviews at intake to support referral processing
• End of episode management
• Review daily discharge reports; verify DC summaries and signed orders are complete and accurate
• Confirm NOMNC is on file for all appropriate discharges
• Process discipline-only and full discharge orders as they arise
• Hospital Hold Process Management
• Manage hospital hold information, inpatient transfer processes, and POC completion for hospitalized patients
• Discharge clients in facility at end of episode as needed
• Manage resumption of care workflows, ensure timely resumption of care, oversee pending delay approvals in the EMR
• Quality & Compliance Monitoring
• Review and track infection control reports
• Monitor for wound score deviations and escalate appropriately
• Review and trend QI events weekly; identify patterns and flag for clinical leadership
• Review and process clinical alerts and potentially avoidable event notifications
• Audit missed visits by clinician and unverified missed visits daily to support appropriate care delivery as well as LUPA risk management; confirm proper documentation and follow-up
• Patient Status Monitoring
• Monitor vital sign parameter alerts for active patients, ensuring appropriate documentation, notifications, and follow-up; escalating to branch Clinical Manager as appropriate
• Review coordination notes for physician updates, medication interactions, and clinically significant medication issues
• Review dashboards for change-in-condition with appropriate clinical judgment and escalation

Qualifications

• Active RN license (required) — clinical judgment is core to this role
• Strong EMR proficiency with HCHB
• Exceptional attention to detail and commitment to documentation accuracy
• Ability to manage high-volume, time-sensitive workflows without losing quality
• Understanding of home health regulatory requirements
• Ability to work independently and manage time effectively in a remote environment
• Clear written and verbal communication; ability to escalate clinical concerns appropriately