Quality Assurance/Registered Nurse

Position Summary
OPA Home Care operates a strict, gated Referral-to-Cash Operating System (v2.2) designed to deliver consistent outcomes regardless of who executes the process. Every stage has one owner, binary “done” definitions recorded in AxisCare, mandatory QA audits, and clear KPIs. OPA has maintained a perfect shift coverage record – zero missed shifts since May 23, 2024. As our Quality Assurance & Operations Administrator, you will execute daily audits, enforce gate compliance, and produce reporting that keeps the pipeline running with discipline and integrity. You will own the audit function across all active pipeline stages and escalate violations without delay.

Important: This role involves reviewing client records that may contain Protected Health Information (PHI). HIPAA training is required and must be completed before AxisCare access is granted. No exceptions.

Key Responsibilities
Core QA & Audit Ownership

• Perform the full Stage 1 QA Audit within 24 hours of every Referral ? Intake completion – verifying lead entry timestamps, contact cadence, SLA execution while client is on the phone, deposit calculation and posting, gate integrity, referral source entry in both required AxisCare locations, and Director of Operations start authorization.
• Expand QA audits to additional stages (Intake ? Care Plan, Staffing, Visit Completion, Billing, and Recruiting pipeline) as those stages are finalized and directed.
• Track stage completion misses by employee and stage. Support corrective action by reporting misses to the task owner and Director of Operations within 24 hours of identification.
• Own the Exception Tracking Protocol: confirm every gate bypass is logged with all four required fields (exception type, reason, approved-by, normalization deadline) and normalized by the applicable deadline – 24 hours for emergency starts, 48 hours for gate overrides. Escalate missed normalizations immediately.
• Run weekly cross-pipeline reviews and support root-cause analysis when lag KPIs fail.
• Deliver daily audit summaries and weekly pipeline reports to the Director of Operations, CEO, and designated team members. Flag gate violations immediately – no batching of critical issues.

Operations Support

• Monitor AxisCare continuously for gate integrity, status accuracy, medically fragile designations, documentation compliance, and system rule adherence.
• Enforce core system rules without exception: one owner per stage, no downstream action before gate confirmation, “if it is not logged in AxisCare, it did not happen,” and no informal modifications.
• Support scheduling, intake, clinical, and billing teams with repeatable administrative and auditing tasks as directed by the Director of Operations.

Compliance & Reporting

• Maintain strict HIPAA compliance in all work involving client data, at all times.
• Produce clear, accurate, and timely audit reports and documentation.
• Participate in process improvement as the company scales and additional OS stages are activated.

Success Metrics

• 100% of assigned QA audits completed within required timeframes.
• 100% of exceptions normalized by deadline or escalated with documented reason before deadline.
• Zero unaddressed critical issues in audit reports – all gate violations flagged same day.
• Reporting delivered on schedule with no gaps.
• Contribution to overall pipeline KPIs: conversion rates, shift coverage, collection rates.

Qualifications

• Must be an RN(required)

2+ years of experience in quality assurance, process auditing, operations coordination, or healthcare administration. Home care, BPO, or healthcare support experience is a strong advantage.

• Demonstrated attention to detail and documented ability to enforce strict processes and rules – including escalating when colleagues are non-compliant.
• Strong proficiency with EMR/EHR or care management systems. AxisCare experience is highly preferred; fast independent learners will be considered.
• Excellent written and spoken English – clear, professional, and precise in all communications.
• Reliable high-speed internet, power backup, and a quiet dedicated workspace for US night-shift hours.
• Experience with HIPAA or equivalent data privacy standards. Candidates without prior HIPAA experience must complete comprehensive training before system access is granted.
• Comfortable working independently with a high degree of self-direction while coordinating with a US-based team via Slack, email , and scheduled calls.

Preferred

• Background in home care, senior care, or healthcare BPO operations.
• Experience creating structured audit summaries and operational reports.
• Familiarity with US healthcare compliance environments or payer operations (VA, Medicaid, private pay).

Compensation & Benefits

• Monthly salary: $1,200 USD. Performance bonus bridges toward higher earnings for strong and consistent performers.
• Paid training on OPA’s Operating System, AxisCare, and HIPAA – completed before system access is granted.
• Opportunity to grow into expanded audit and operations scope as the company scales.

Why Join OPA?
You will play a foundational role in protecting a rigorous, systems-driven operation that delivers exceptional reliability to clients and families. OPA has maintained zero missed shifts since May 23, 2024 – a record this role directly protects. If you are process-oriented, thrive on detail and consistency, and want to contribute to a growing US home care company while working remotely from the Philippines, this role is built for you.