Supervisor, Medical Review Audit (Clinical) (Fully Remote)

Machinify; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Machinify is seeking a results-driven leader to supervise a clinical auditing team, ensuring quality and productivity while upholding Medicare SNF audit standards. You will guide performance reviews, coaching, and team meetings, and translate audit findings into actionable improvements.

The role requires collaboration with QA, Appeals, and client teams to address operational challenges and support provider training and reporting. Join a company delivering healthcare insights at scale.

Responsibilities

• Directly supervise a team of clinical auditors and set productivity and quality expectations.
• Conduct regular performance reviews, coaching, and feedback sessions.
• Lead team meetings and manage time, attendance, and scheduling.
• Serve as primary subject matter authority for SNF audit programs with Medicare rules.
• Oversee audit determinations on qualifying hospital stays, physician certification, and MDS coding accuracy.
• Collaborate with QA to translate findings into actionable feedback.
• Provide reporting and operational updates on team activity and metrics.
• Collaborate with QA, Appeals, and segment specialists to resolve operational problems.
• Participate in client-facing meetings and support provider training.

Job description

Team Leadership & Performance Management:

• Directly supervise a team of clinical auditors and set clear productivity and quality expectations.
• Conduct regular performance reviews, coaching, and feedback sessions.
• Lead team meetings and monitor time, attendance, and scheduling.

SNF Audit Oversight & Quality:

• Serve as primary subject matter authority for SNF audit programs, maintaining knowledge of Medicare rules.
• Oversee audit determinations on qualifying hospital stays, physician certification, and MDS coding accuracy.
• Collaborate with QA team to translate findings into actionable feedback.

Cross-Functional & Strategic Contribution:

• Provide reporting and operational updates to management on team activity and metrics.
• Collaborate with QA, Appeals, and segment specialists to resolve operational problems.
• Participate in client-facing meetings and support provider training.

Machinify

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, the company combines a configurable AI-powered platform with best-in-class expertise to drive down healthcare costs.