Healthcare Quality Assurance Manager (Team Lead)

Role Overview

Reporting to the Director of Clinical Services, the Registered Nurse in this quality assurance role reviews nursing documentation and related clinical records before approval and electronic submission. The work helps ensure records accurately reflect the plan of care, support appropriate reimbursement, and give clinical and administrative teams clear information to improve care and address documentation gaps.

Key Responsibilities

• Check nurses’ notes for accuracy, completeness, and consistency with the plan of care; return records requiring correction before approval or submission.
• Compare nursing documentation with physician orders, medication profiles, and aide care plans to identify discrepancies or missing information.
• Review local clinical records for Medicaid and other episodic payers, assessing documentation quality, care delivered, visit use, physician contacts, care-plan adherence, and communication among disciplines.
• Coordinate with clinical team members, attending physicians, and caregivers to support appropriate care decisions and outcome planning.
• Identify recurring clinical and documentation deficiencies, track trends, and guide administrative and clinical staff in addressing them.
• Contribute to performance improvement work and maintain current clinical knowledge through internal and external training.
• Attend biweekly meetings, raise ongoing quality assurance and clinical concerns, and submit weekly reports summarizing notes reviewed and issues needing follow-up.
• Carry out other duties as assigned.

Requirements & Qualifications

• Bachelor’s degree and current Registered Nurse licensure and registration in good standing.
• At least six years of professional experience.
• Strong clinical documentation review skills and the ability to assess records against orders and care plans.
• Excellent written, verbal, interpersonal, and organizational skills.
• Sound judgment, initiative, and the ability to work independently as well as collaboratively.
• Ability to manage competing priorities, handle multiple tasks in a fast-paced setting, and maintain close attention to detail.
• Problem-solving and leadership skills, including the ability to interpret instructions and provide clear direction to staff.