Oklahoma RN Regulatory Review Specialist

Job Summary

Seeking a detail-oriented Oklahoma RN Regulatory Review Specialist to work full-time in a remote capacity, responsible for supporting medical reviews, managing audit responses, and ensuring compliance with healthcare regulations across home health and hospice operations.

Key responsibilities

• Support payer audits and medical record reviews, ensuring timely and accurate documentation submissions
• Manage medical review requests and appeals related to CMS contractors and regulatory agencies
• Participate in compliance monitoring initiatives and assist with risk identification activities

Required qualifications

• Current Registered Nurse (RN) license
• Minimum 3 years of clinical operational leadership or supervision experience within Home Health and/or Hospice
• Strong knowledge of CMS Home Health regulations and state/federal licensing standards
• Experience performing clinical chart reviews and documentation audits
• Ability to independently prioritize and manage work in a remote environment