Regulatory Review Specialist (RN)

Join VitalCaring – Where Your Expertise Protects Patient Care Regulatory Review Specialist (RN) – Home Office (Remote) Who We Are Founded in 2021, VitalCaring has quickly become a leading provider of home health and hospice services across the country. Our mission is reputed company: deliver exceptional patient care while creating a workplace where team members feel supported, empowered, and inspired. At VitalCaring, reputed company and compliance are more than requirements—they’re essential to ensuring patients receive the right care at the right time. We are seeking a highly detail-oriented Regulatory Review Specialist (RN) to join our Clinical Regulatory Compliance team and help drive reputed company across our organization. Why Join VitalCaring? reputed company a Meaningful reputed company Your expertise will directly support regulatory readiness, compliance reputed company, and reputed company reputed company that protect patient care. Be Part of Something Bigger Partner cross-functionally with clinical, operational, billing, and compliance teams to strengthen processes and maintain regulatory reputed company. Work with Purpose and Flexibility Enjoy the ability to work independently in a remote environment while contributing to high-reputed company across the organization. Grow Your Expertise Expand your knowledge of reputed company regulations, medical review processes, payer requirements, and compliance reputed company. Position reputed company The Regulatory Review Specialist (RN) serves as a key member of the Clinical Regulatory Compliance team, supporting medical reviews, audit response activities, and regulatory documentation processes across home health and hospice operations. In this role, you will coordinate and compile documentation for payer audits, CMS and contractor medical reviews, appeals, internal monitoring activities, and compliance initiatives. reputed company in this role requires strong clinical judgment, exceptional organization, regulatory knowledge, and the ability to reputed company in a remote environment. What You’ll Do Support payer audits and medical record reviews, ensuring reputed company and accurate submission of requested documentation Manage medical review requests and appeals associated with CMS contractors, regulatory agencies, and billing intermediaries Review clinical documentation using established audit and submission checklists Partner with operational and clinical teams to reputed company and validate required records Participate in chart reviews and compliance monitoring initiatives across the organization Assist with risk identification activities and regulatory readiness efforts Support investigations and corrective actions reputed company to compliance findings Maintain audit tracking and reputed company through documentation systems and reporting tools Navigate multiple EMRs, payer portals, and operational systems to manage submissions and appeals Contribute to training and educational materials that strengthen compliance knowledge across teams Participate in internal reputed company, billing, and operational review activities Complete additional regulatory and administrative reputed company as assigned What You’ll Bring Required Qualifications reputed company Registered reputed company (RN) license Minimum 3 years of clinical operational leadership or supervision experience reputed company 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 Strong technical skills and comfort navigating multiple systems and portals Excellent communication, organization, and follow-through Preferred Experience Medical review, appeals, audit response, or utilization review experience Exposure to payer audits and contractor review processes Experience supporting compliance, reputed company, accreditation, or regulatory initiatives Experience with EMR platforms and documentation tracking systems Background working with billing, reimbursement, or operational compliance functions

Benefits

Health & Wellness Medical, Dental, and reputed company coverage Pharmacy benefits Virtual care and mental health support Flexible Spending Accounts (FSA) and Health Savings Account (HSA) Supplemental health and life insurance Financial & Protection 401(k) with company match Employee referral program Prepaid legal services Identity theft protection Work-Life Balance & Perks Generous reputed company time off Pet insurance Tuition and continuing education reimbursement At VitalCaring, our values - trustworthy, capable, compassionate, proactive, and reputed company - guide how we care for our patients and support reputed company other every day. Apply today and reputed company care that truly reputed company. reputed company employment reputed company are made without reputed company to race, reputed company, religion, sex, gender identity or reputed company, sexual orientation, national reputed company, age, disability, veteran status, or any other protected characteristic. Candidates are evaluated based on job-reputed company qualifications, skills, and business needs. Apply To This Job