Medical Health Care Program Analyst Jobs (NOW HIRING)

Classification: Full-Time | Exempt

Reports To: Owner/President/CEO; Administrator of Record

Service Lines: Title 28 Ch. 601/611 (Home Health) | Title 55 Ch. 6400 (Residential Habilitation)

License Required: Registered Nurse (RN) — Active Pennsylvania License Accreditation: CARF-Accredited Organization

Position Summary

The Program Director / Director of Nursing (PD/DON) provides dual-function leadership across Quality Healthcare Group's home health and residential habilitation service lines. This position holds regulatory responsibility as the designated clinical authority under 28 Pa. Code Chapter 601 and program oversight authority under 55 Pa. Code Chapter 6400, ensuring seamless coordination between both departments while upholding compliance with all applicable Pennsylvania DHS, ODP, OLTL, and CARF standards.

An active Pennsylvania RN license is required. The RN credential satisfies the Director of Nursing requirement under Title 28 Chapter 601. For the residential habilitation program under Chapter 6400, regulatory minimums require a bachelor's degree in a human services field plus IDD experience; the RN license exceeds those minimums and supports integrated clinical oversight across both lines.

Essential Duties & Responsibilities

A. Home Health Services (Chapter 601 / 611)

• Serve as designated Director of Nursing per 28 Pa. Code § 601.31; maintain all DON-specific records and reporting obligations

• Provide clinical supervision of field nursing staff (RNs, LPNs), home health aides, and therapy staff

• Review and approve Plans of Care (485), physician orders, and OASIS/start-of-care assessments

• Ensure EVV compliance via HHAeXchange and Sandata; monitor visit verification and billing integrity

• Conduct and document clinical record audits; ensure documentation supports PROMISe billing under applicable OLTL/Community HealthChoices waiver codes

• Manage referral-to-admission workflow; coordinate with MCOs and managed care representatives

• Oversee infection control, adverse event reporting, and clinical incident management per Chapter 601 and CARF standards

B. Residential Habilitation Services (Chapter 6400)

• Serve as Program Director with operational and programmatic oversight of all Chapter 6400 residential homes

• Supervise Program Specialists, House Managers, and DSPs; ensure staffing ratios, training compliance, and clearance currency per 6400 requirements

• Oversee development, implementation, and review of Individual Support Plans (ISPs) in coordination with Supports Coordinators and SCOs

• Ensure documentation in Therap meets ODP waiver, DHS licensing, and CARF standards; review and approve service notes, goal data, and behavior support documentation

• Conduct scheduled and unannounced site visits; document findings and implement corrective actions

• Coordinate health, medical, and psychiatric needs of residential individuals; serve as primary clinical liaison to attending physicians, specialists, and pharmacies

• Lead incident investigation and ensure timely HCSIS/EIM reporting per ODP Incident Management Bulletin requirements

• Manage individual petty cash accounts, household budgets, and Medicaid financial records per 6400.54 and agency policy

C. Quality Assurance, QAPI & Compliance

• Lead agency-wide QAPI process across both service lines; set measurable performance indicators, track outcomes, and present quarterly reports to leadership

• Prepare and maintain CARF accreditation readiness; serve as primary point of contact for surveys across both programs

• Ensure state licensure compliance for home health (DHS Bureau of Home Health) and residential habilitation (ODP); manage corrective action plans from inspections

• Maintain updated policies and procedures in alignment with current regulatory revisions to Title 28 and Title 55

• Oversee mandatory training compliance including orientation, annual in-service, ODP-required competencies, and CARF training tracks

D. Human Resources & Administrative Oversight

• Participate in recruitment, interviewing, and onboarding of clinical and direct care staff across both divisions

• Ensure all staff maintain current FBI, PA State Police, and Child Abuse History clearances; manage clearance tracking

• Conduct or oversee performance evaluations; administer corrective action and disciplinary procedures in coordination with HR

• Coordinate with billing and finance team to ensure documentation integrity supports accurate PROMISe, HHAeXchange, and Therap submissions

• Monitor department budgets; report variances to Administrator/CEO

Qualifications

Required

• Active Pennsylvania Registered Nurse (RN) license — unencumbered

• Minimum 3 years of clinical nursing experience; at least 2 years in home health or community health

• Minimum 2 years of supervisory or program management experience

• Working knowledge of 28 Pa. Code Chapters 601/611 and 55 Pa. Code Chapter 6400

• Familiarity with Pennsylvania ODP, OLTL, and Community HealthChoices waiver structures

• Valid Pennsylvania driver's license and reliable transportation

Preferred

• Bachelor's or Master's degree in Nursing, Healthcare Administration, or related field

• Prior DON or Program Director experience in a home health agency or IDD residential program

• Experience with Therap, HHAeXchange, Sandata, and/or PROMISe

• CARF accreditation survey experience

• IDD-specific clinical or program experience

Required Clearances (Prior to Start)

• PA State Police Criminal Record Check (Act 34)

• FBI Criminal History — fingerprint-based (Act 73)

• PA Child Abuse History Clearance (Act 151)

• OIG/SAM Federal Exclusion Verification

• Current TB screening / health assessment per agency policy

Quality Healthcare Group, Inc. is an Equal Opportunity Employer.