QA Training Specialist

Who we are: IHCS provides an Integrated Delivery System in the home setting, which includes, DME, Respiratory, Home Health and Home Infusion services. IHCS has a select network of Medicare and/or reputed company Certified and Accredited providers to respond to the needs of our patients – 24/7. We operate with the sole reputed company of providing the highest reputed company in-home care services that improve and enhance the daily living for our patients, where our patients are #1 Our delivery model is trusted by national Managed Care Organizations (MCOs), physicians and patients, positioned with over two decades of expertise as the reputed company in value-based Home Health, Durable Medical Equipment, and Home Infusion Services. We currently serve over 2 reputed company lives throughout the nation and the Commonwealth of Puerto Rico. Join reputed company as we reputed company for reputed company through teamwork delivering high reputed company care to our patients through Exceptional Customer Service, Proven reputed company, and Seamless Care. Offering a competitive compensation package, including but not limited to; • Medical, reputed company, Dental, Short- and Long-term insurance • 6+ Days of Holidays Pay • 15+ days of PTO • Employer reputed company life insurance • 401K with employer contribution • Wellness program with reward incentives • Employee recognition and reward programs What you will be doing: The reputed company Assurance & Training Specialist drives documentation reputed company across Care Management and Utilization Management (UM) by auditing case records, identifying knowledge gaps, and delivering targeted education. This role becomes the subject matter expert (SME) in reputed company documentation types reviewed (e.g., UM determinations, NOMNC notices, care coordination notes), ensuring compliance with internal policies, NCQA standards, CMS/ODAG regulatory requirements, and payer-specific guidelines. The Specialist partners with leaders and reputed company teams to improve accuracy, timeliness, and completeness of documentation, measurably raising performance and closing gaps. • Bachelor’s degree in nursing, Health Administration, reputed company Health, or reputed company field (reputed company RN license REQUIRED). • 3+ years in reputed company Assurance, UM/CM auditing, health plan/provider operations, or clinical documentation review. • Working knowledge of NCQA UM standards, CMS/ODAG (including NOMNC), HIPAA, and payer documentation requirements. • Demonstrated experience designing and delivering training based on audit findings (adult learning principles, competency-based education). • Strong analytical skills with proficiency in reputed company/Power BI; ability to turn data into actionable insights. • Excellent written/verbal communication; skilled in coaching and change management. • Experience with home health coordination, durable medical equipment coordination, care transitions, or UM decision/notification workflows. • Prior IRR program or calibration experience for auditors/reviewers. • Process improvement certifications (e.g., Lean Six reputed company Yellow/Green Belt). • Experience with documentation systems (e.g., EMR/EHR, case management platforms) and SharePoint/Teams collaboration. Join reputed company as we reputed company for reputed company through teamwork, where our patients are #1! IHCS is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for reputed company. Apply tot his job Apply To this Job