Customer Insights Manager, Home Health/Hospice (US, Remote)

The role

You will act as the HH&H compliance subject matter expert to bridge clinical realities with product, engineering, sales, and implementation teams. You will translate regulatory frameworks into product requirements and help build compliance dashboards and custom rules engines.

What you will do

• Translate CMS Conditions of Participation, state regulations, accreditation standards, and payer requirements into operational workflows and AI rule sets
• Maintain compliance rule libraries covering OASIS-E, HOPE, hospice eligibility, PDGM coding, and SDoH capture
• Provide clinical validation and subject matter expertise for AI-driven compliance prompts and dashboard checks
• Lead discovery sessions with HH&H executives, QA/QAPI directors, and clinicians
• Support compliance implementations including data schema validation, EHR ingestion review, and custom rules development
• Serve as the HH&H compliance SME during customer meetings, QBRs, and onsite visits
• Educate internal teams on HH&H compliance personas, regulatory frameworks, and market dynamics
• Partner with Product, Clinical Strategy, Engineering, and Sales Engineering
• Monitor changes in CMS regulations, MAC and payer requirements, and accreditation standards

Required qualifications

• Clinical licensure and direct patient care experience in home health or hospice (RN, PT, OT, SLP, SW, or equivalent)
• 5+ years in quality assurance, compliance, or clinical operations leadership within a home health, hospice, or combined HH&H organization
• Deep working knowledge of CMS Conditions of Participation, OASIS-E, HOPE, PDGM, and hospice eligibility/recertification documentation standards
• Hands-on experience with audit preparation (CMS surveys, state surveys, ADRs, ZPIC/UPIC audits), QAPI programs, and corrective action planning
• Familiarity with major HH&H EHR systems (e.g., HCHB/Homecare Homebase, WellSky/Kinnser, MatrixCare, Netsmart, Careficient, Healthwyse)
• Strong project management skills
• Experience with LLM prompt engineering, AI model validation, or data-driven quality improvement methodologies
• Ability to travel domestically (4-10 visits a year) with potential for international travel

Nice to have

• Director level or above preferred for compliance or clinical operations leadership
• Background in revenue cycle management, coding compliance, or billing operations in HH&H
• Certifications such as COS-C, CHC, CPHQ, or HCS-D
• Experience navigating PDGM recoupment risk, hospice fraud enforcement, or CMS TPE reviews

Benefits

• Competitive health and well-being benefits
• Mental healthcare support
• Life and AD&D insurance
• Significant equity
• 401(k) plans matched to 4%
• Company sponsored retirement plan
• Global business travel insurance for you and any dependents
• Domestic conference budget
• Annual learning & development stipend
• Remote work stipend
• Generous PTO
• Additional mental health days

About the company

Eleos Health builds the system of action for community-based care, helping behavioral health, hospice, home health, and other care teams reduce administrative burden. Their Polaris AI works alongside clinicians to understand care in real time.