• Conduct regular quality assurance audits of patient records, care plans, and clinical documentation • Perform OASIS record reviews according to agency-defined parameters and required timeframes • Review and validate 12–16 OASIS assessments per day for accuracy, completeness, and compliance (no coding required) • Identify trends, deficiencies, and risk areas, and develop corrective action plans • Collaborate with nursing and interdisciplinary team members to ensure compliance with clinical standards, regulations, and agency policies • Provide education, feedback, and training to nursing staff related to documentation quality and regulatory compliance • Participate in interdisciplinary team meetings to discuss patient care quality and improvement opportunities • Maintain accurate, organized, and complete records of all QA activities and findings • Demonstrate thorough knowledge of current Medicare guidelines and Home Health Conditions of Participation (CoPs) • Support agency preparedness for surveys, audits, and regulatory reviews

This role serves as a high level clinical quality and training leader within the Coding & OASIS review space. It goes beyond day to day quality checks and focuses on elevating reviewer performance, supporting client onboarding, aligning processes across teams, and partnering closely with both stateside and offshore reviewers. Acting as a key resource to managers, clients, and Quality Assurance Reviewers (QARs), this role ensures consistent quality outcomes, strong operational alignment, and a seamless reviewer experience across all supported programs. About Netsmart At Netsmart, improving care delivery isn’t just our aspiration; it’s our passion! For more than 50 years, we’ve been a healthcare software company developing technology and providing services in the behavioral health, human services, and Post‑Acute markets. We collaborate with organizations and partner with our clients across the care spectrum to anticipate challenges, identify obstacles and recognize new opportunities as healthcare evolves. We continuously strive to advance our Netsmart technologies and offerings beyond the EHR by embracing new technology trends that empower healthcare professionals to provide the best possible care. OASIS QA Specialist This role serves as a high‑level clinical quality and training leader within the Coding & OASIS review space. It goes beyond day‑to‑day quality checks and focuses on elevating reviewer performance, supporting client onboarding, aligning processes across teams, and partnering closely with both stateside and offshore reviewers. Acting as a key resource to managers, clients, and Quality Assurance Reviewers (QARs), this role ensures consistent quality outcomes, strong operational alignment, and a seamless reviewer experience across all supported programs. Responsibilities - Oversee Coding & OASIS staff competency to ensure accuracy, consistency, and compliance with guidelines. - Develop and deliver new‑hire orientation and ongoing training, including client‑specific processes and updates. - Conduct Quality Assurance (QA) reviews, document findings, identify trends, and collaborate closely with QARs performing day‑to‑day QA. - Serve as the expert resource for complex Coding & OASIS questions and maintain updated knowledge resources. - Partner with managers, clients, and internal teams to support client onboarding, quality discussions, and process alignment. - Work collaboratively with both stateside and offshore (India‑based) review teams to support training, quality standards, and workflow consistency. - Test and provide feedback on McBee Clinical Review platform functionality. - Communicate quality concerns to all appropriate stakeholders and support resolution actions. Required Qualifications - At least 4 years of experience in Coding & OASIS review - HCS-D certification and HCS-O or COS-C OASIS certification - Expert in ICD-10 coding and OASIS guidelines - Proficient in home health industry regulations and guidelines - Excellent communication and presentation skills - Working knowledge of Microsoft Office Preferred Qualifications - Advanced clinical degree - Active clinical license (e.g., RN, PT, OT, SP) - CPHQ certification - HCS-H certification Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate. Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart’s sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart’s third party screening provider. If you are located in a state which grants you the right to receive information on salary range, pay scale, description of benefits or other compensation for this position, please use this form to request details which you may be legally entitled. All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position. Netsmart's Job Applicant Privacy Notice may be found here.

• Manage Quality Reporting Process • Monitor closed QREs within the ticketing system to ensure investigations are finalized and properly documented • Collaborate with external teams to confirm accuracy, completeness, and resolution of reported events • Verify data accuracy and completeness to support tracking, trending, and reporting • Close tickets in alignment with established procedures and timelines • Maintain data quality and reporting readiness through continuous system monitoring • Generate and distribute monthly QRE reports for stakeholders and clients • Maintain adherence to internal quality standards and regulatory guidelines by supporting AnewHealth quality and compliance efforts • Partner with service line and department leaders to identify improvement opportunities, create and support in-service training, and deliver onboarding education • Assist in the development, implementation, and evaluation of internal and external performance improvement initiatives • Support the collection and sharing of best practices across teams to enhance consistency and quality of service delivery • Generate and distribute quality and performance reports to internal stakeholders and clients • Monitor referral source reports, analyze trends, and identify opportunities for improvement • Coordinate and document monthly client communication reports • Participate in QI meetings and maintain meeting minutes • Support the development and updates of the annual QI Plan and Program • Provide operational support to other business units during periods of high volume, as needed

Company Description Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers Job Description The RCM Quality Assurance Auditor (RCM Quality & Audit Specialist) is responsible for ensuring the accuracy, efficiency, and compliance of the organization's revenue cycle processes. This role involves conducting audits, monitoring key performance indicators, identifying process improvements, and ensuring compliance with industry standards and regulations. his includes, but is not limited to claims, denial management, and functions for both onshore and offshore resources. The ideal candidate should have a strong background in medical billing, coding, and accounts receivable, with a focus on quality assurance and process auditing. Primary Job Duties: - Conduct quality reviews, audit revenue cycle claims and workflows against established standard operating procedures (SOPs) • Develop, collect, analyze, report and measure multiple quality improvement initiatives that supports RCM operational functions • Create and maintain quality measurements to track improvements in individual and team performance scores • Identify potential deficiencies in processes via analysis and trends • Create reports and deliver assessment/evaluation results to appropriate levels of leadership • Research and identify the “root cause analysis” in process improvement (eg. Ability to identify when a function/action was performed that is not included in the SOP or documentation available) and utilize audit findings to report trends and recommended training • Assist with establishing, updating and communicating new and existing procedures • Analyze and measure results of implemented policies and changes • Collaborate with various RCM Leaders and internal partners to ensure goals are being met • Serve as a SME on all RCM workflows that are being audited • Participate in special projects, audits and process improvements in support of quality assurance initiatives • Other duties, as assigned i.e. coordinate and serve as supplemental support to the National Training Team Qualifications - Associate’s or bachelor’s degree preferred - 3+ years experience in an auditing/QA role or equivalent RCM job related experience - 2+ years experience with athenaHeath and/or athenaOne preferred - Experience working with offshore resources - Excel skills to include the ability to use formulas to analyze data, create graphs and pivot tables - Advanced working knowledge of Google Suite: Sheets, Slides and Forms - Experience managing data located in multiple software systems - Experience documenting clearly defined processes, standard operating procedures and policies - Demonstrates effective written and verbal communication skills with the ability to self-edit - Must demonstrate strong interpersonal skills to interact positively and effectively - Ability to work in a very fast-paced and changing work environment - Must comply with HIPAA rules and regulations - Collaborative, customer-focused and able to create visible value - Ability to prioritize tasks, use sound judgment, and remain organized - Strong attention to detail and time management skills - Ability to accept constructive feedback and work towards self-improvement and professional - growth The salary range for this role is $65,000,00 to $70,000,00 in base pay and exclusive of any bonus or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information All your information will be kept confidential according to EEO guidelines. Technical Requirements (for remote workers only, not applicable for onsite/in office work): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law. - Department: Revenue Cycle