Clinical & Quality Operations Regulatory Coordinator in Keene, New Hampshire at Home Healthcare and Hospice Community Services

Clinical & Quality Operations Regulatory Coordinator

The Clinical & Quality Operations Regulatory Coordinator supports regulatory compliance, survey readiness, quality assurance, and performance improvement activities across home health, hospice, and community-based services. This role ensures compliance with CMS Conditions of Participation, NH state regulations, and accreditation standards while supporting chart audits, appeals management, policy development, and corrective action initiatives.

Key Responsibilities:

• Coordinate survey readiness activities for CMS, NH DHHS, specialty programs, and accrediting organizations
• Conduct clinical record audits to ensure documentation quality, compliance, and plan-of-care adherence
• Manage ADRs, claim denials, and appeals, including tracking outcomes and identifying root causes
• Develop, review, and maintain clinical policies and procedures aligned with regulatory requirements and best practices
• Support QAPI initiatives through quality data analysis, reporting, and performance improvement projects
• Provide staff education related to documentation standards, regulatory updates, and survey readiness
• Collaborate with clinical, billing, compliance, and leadership teams to improve workflows, maintain compliance, and support quality outcomes

This position serves as a key resource for regulatory interpretation, clinical quality improvement, and operational best practices across the organization.

Experience

• Minimum 5-7 years in:
  • Home health, hospice, or community-based care
• Demonstrated experience with:
  • State or CMS survey process
  • Formal fiscal auditing/response (CERT, TPE, OIG)
  • Clinical documentation review/auditing

Required Competencies

• Strong knowledge of:
  • CMS Conditions of Participation (Home Health & Hospice)
  • New Hampshire licensing requirements
• Experience in:
  • Chart audits and quality review
  • Policy writing and compliance
  • Denials and appeals management

Skills & Abilities

• Analytical and detail-oriented
• Strong documentation and audit skills
• Ability to interpret and apply regulations
• Excellent communication and staff education skills
• Ability to manage multiple priorities and deadlines
• High level of discretion and professionalism