Supervisor, Clinical Compliance (RN) - Remote

Guidehealth

$85K — $90K *
US-AnywhereRemote in Rockford, IL
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Certified/Registered Medical Assistant (CMA/RMA) or equivalent clinical background
  • 3+ years of experience as a Medical Assistant with patient outreach
  • 1+ years of supervisory experience, ideally in a remote context
  • Strong knowledge of social determinants of health (SDOH)
  • High emotional intelligence with adept communication and conflict resolution skills
  • Ability to navigate a fast-paced, dynamic work environment
  • Proficient in electronic health records (EHRs) and telehealth technologies.

Responsibilities

  • Supervise daily operations of clinical compliance auditors and specialists
  • Act as the clinical services liaison for senior management
  • Coordinate training and ongoing performance reviews for clinical staff
  • Help develop and manage meeting agendas for utilization management reports
  • Facilitate adherence to utilization management and population health management plans
  • Serve as a reviewer for compliance audits and denial processes
  • Ensure confidentiality and assist with internal/external audits.

Benefits

  • Fully remote work environment for better work-life balance
  • Comprehensive Medical, Dental, and Vision plans
  • 401(k) plan with a 3% employer match
  • Life and Disability insurance for peace of mind
  • Employee Assistance Program for additional support
  • Paid time off to encourage personal wellbeing
  • Paid parental leave for new family members
  • Resources dedicated to professional growth and development.
Full Job Description
We are seeking a highly organized and emotionally intelligent Remote Medical Assistant - Healthguide™ Supervisor to lead a team of remote medical assistants - Healthguides™ conducting patient outreach for highly impactable and transition-of-care patients. This role is critical in addressing social determinants of health (SDOH), resolving access barriers, and ensuring high-touch patient engagement in a fast-paced, mission-driven environment. WHAT YOU'LL BE DOING • Supervising and directing the day-to-day operations of the clinical compliance auditors and specialists. • Serving as the clinical services liaison to senior management and other company leaders and assisting in developing coordinated and efficient companywide team processes. • Assisting with coordinating orientation, training, continuing education, and ongoing performance monitoring for clinical compliance auditors and other departments as required. • Working with Leadership to promote staff members' continued professional growth and education. • In conjunction with the Compliance Manager, UM Manager, and PHM Manager, overseeing and assisting with developing and managing the agenda and meeting minutes for the monthly utilization management data reported to the Independent Physician Association (IPA) UM Committee. • Assisting with facilitating UM and PHM Plan development and adherence. • Identifying UM and PHM Plan requirements and assisting in creating auditing guidelines to ensure clinical staff continue to meet minimum requirements, including quarterly, semiannual, and annual submission requirements set forth in the UM and PHM Plans. • Serving as a secondary reviewer to ensure adherence to the denial process and all denial compliance audit requirements, reviewing documentation, and ensuring all documentation is submitted in a timely manner. • Supporting the maintenance of confidentiality related to all computer programs, medical records, and other data. • Providing critical-thinking skills, decisive judgment, and the ability to work with minimal supervision. • Ensuring meeting minutes are completed, signed, and uploaded in accordance with UM and PHM Plan requirements. • Assisting with all internal and external audit reviews and submissions. • Completing monthly check-ins with clinical compliance auditors and specialists. Qualifications WHAT YOU'LL NEED FOR SUCCESS • Certified/Registered Medical Assistant (CMA/RMA) or equivalent clinical background. • 3+ years of experience as a Medical Assistant, including patient outreach or care coordination. • 1+ years of experience in a supervisory or leadership role, preferably in a remote setting. • Strong understanding of SDOH and barriers to healthcare access. • High emotional intelligence (EQ) with excellent communication, coaching, and conflict-resolution skills. • Ability to thrive in a fast-paced, high-touch environment with shifting priorities. • Proficiency in electronic health records (EHRs), telehealth platforms, and data tracking tools. WHAT WE'D LOVE YOU TO HAVE • Claims processing experience • Coding certificates are a plus Additional Information The salary range for this role will depend on the background and experience of the individual, ranging from $85,000.00 to $90,000.00 per year. BENEFITS: While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include: • Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs. • Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered. • Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution. • Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected. • Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times. • Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals. • Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need. • Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us. All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. Temporary employees and contractors are not eligible for benefits. COMPENSATION: The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.

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