Remote Quality Improvement Supervisor — Claims & Data Analytics

Avalon Healthcare Solutions; United States; On-site; USD 90,000 - 130,000; Full time

Job summary

Avalon Healthcare Solutions seeks a Supervisor, Quality Improvement to lead a team of Quality Improvement Specialists. You will supervise, coach, develop, and evaluate staff; oversee audits of claims data, identify trends, and develop corrective actions.

The role partners with Clinical Operations, Medical Policy, Configuration, Coding, Translation, Client Delivery, and other teams to drive performance and ensure compliance with regulatory standards.

Qualifications

• 5+ years of healthcare quality improvement, auditing, claims analysis, or related healthcare operations experience.
• 2–3 years of supervisory, team lead, or people leadership experience.
• Bachelor's degree in Healthcare Administration, Business, Nursing, Health Information Management, or a related field or equivalent combination of education and relevant experience.
• Strong knowledge of healthcare claims processing, medical billing, reimbursement methodologies, and medical coding.

Responsibilities

• Supervise, coach, develop, and evaluate a team of Quality Improvement Specialists.
• Establish team goals, performance expectations, and productivity standards.
• Monitor workload distribution and ensure timely completion of quality audits, reporting, and improvement initiatives.
• Provide ongoing training, mentoring, and professional development opportunities.
• Collaborate with cross-functional teams to ensure accurate implementation of medical and claims payment policies.

Skills

Healthcare quality improvement

Claims analysis

Quality auditing

Analytical thinking

Education

Bachelor's degree in Healthcare Administration

Tools

Power BI

SQL

JIRA

Job description

Avalon Healthcare Solutions seeks a Supervisor, Quality Improvement to lead a team of Quality Improvement Specialists. You will supervise, coach, develop, and evaluate staff; oversee audits of claims data, identify trends, and develop corrective actions.

The role partners with Clinical Operations, Medical Policy, Configuration, Coding, Translation, Client Delivery, and other teams to drive performance and ensure compliance with regulatory standards.