Registered Nurse Regulatory Review

Job Summary

Seeking a detail-oriented Regulatory Review Specialist (RN) to join the Clinical Regulatory Compliance team in a full-time remote position, where the specialist will manage medical reviews, audit responses, and regulatory documentation processes to ensure compliance and quality outcomes in home health and hospice operations.

Key responsibilities

• Support payer audits and medical record reviews, ensuring timely and accurate submission of documentation
• Manage medical review requests and appeals associated with CMS contractors and regulatory agencies
• Participate in chart reviews and compliance monitoring initiatives across the organization

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