Now hiring

Clinical QA Nurse (RN) @ Claim Health

New York City, New York, USOnsiteFull-time
Apply with ResuMinder

Opens on the employer's site

About this role

About the RoleWe're hiring a Registered Nurse with deep home health and hospice experience to own the clinical quality of the documentation flowing through our AI platform.

Our automations review referrals, OASIS documentation, certifications, physician orders, hospice election forms, face-to-face documentation, and supporting clinical records before they reach billing and authorization workflows. Your job is to ensure those automations make clinically sound decisions, identify where they fail, and continuously improve their accuracy.

You'll work at the intersection of clinical expertise, quality assurance, and AI. Rather than reviewing a handful of patient charts each day, you'll help build systems that review thousands correctly.

This is not a bedside or utilization review position. It's an operations and quality role for a nurse who enjoys finding edge cases, improving processes, and translating clinical judgment into scalable automation.

What You'll DoAudit clinical QA performanceReview charts processed by our clinical automation platform for accuracy, completeness, and consistency. Validate whether documentation supports services, identify incorrect classifications, and investigate why automation errors occurred.

Improve clinical automation logicPartner with engineering and product teams to refine how our AI evaluates clinical documentation. You'll identify where automations miss important clinical nuances, recommend decision rules, and validate improvements before they're deployed.

Build clinical review standardsDevelop SOPs that define how clinical documentation should be reviewed across home health and hospice. Standardize quality expectations while accounting for agency-specific workflows and payer requirements.

Support customer implementationsWork directly with agencies to understand their documentation standards, clinical workflows, and compliance expectations. Help configure automations that align with each client's operational processes.

Drive quality metricsMeasure and improve documentation quality, automation accuracy, exception rates, clinical escalations, and rework. Continuously identify opportunities to improve automation performance.

What We're Looking ForRequiredActive RN license (NY or compact license preferred)

3+ years of home health and/or hospice clinical experience

Strong understanding of OASIS documentation and home health eligibility requirements

Experience reviewing physician orders, certifications, plans of care, face-to-face documentation, and hospice election paperwork

Hands-on experience with HomeCare HomeBase (HCHB), Axxess, and WellSky; KanTime a plus

Strong understanding of Medicare home health and hospice documentation requirements

Experience writing SOPs, QA guidelines, or training documentation

Excellent attention to detail and pattern recognition

Comfortable working in a fast-paced startup environment

Nice to HaveQA, Clinical Documentation Integrity (CDI), or Compliance experience

Experience with AI, workflow automation, or healthcare technology companies

Familiarity with referral platforms including Careport and Forcura

Experience implementing or optimizing EMR workflows

Why This RoleScale your clinical expertise. Help AI review thousands of charts instead of reviewing them one at a time.

Own quality. Your feedback directly improves the clinical accuracy of our platform across every customer.

Influence the product. Work side-by-side with engineering to shape how AI understands home health and hospice documentation.

Skills

Operations

Ready to apply?

Install the ResuMinder extension and we'll auto-fill the application in seconds — no rewriting.

See how your CV scores