Supervisor, Medical Review Audit (Clinical)

The role

This working supervisor leads a remote team of clinical auditors performing medical record reviews. The role provides primary oversight of Skilled Nursing Facility (SNF) audits.

What you will do

• Directly supervise a team of clinical auditors and audit associates.
• Conduct performance reviews, coaching, and feedback sessions.
• Lead regular team meetings in a remote environment.
• Monitor and manage time, attendance, and scheduling.
• Identify training gaps and coordinate development and onboarding.
• Serve as the primary subject matter authority for SNF audit programs.
• Perform a limited volume of SNF claim reviews.
• Oversee audit determinations on qualifying hospital stays, physician certification, and MDS coding accuracy.
• Collaborate with the QA team to translate findings into actionable feedback.
• Provide reporting and operational updates to management.

Required qualifications

• Active, unrestricted nursing license in good standing.
• Not sanctioned or excluded from Medicare by OIG.
• 3+ years of direct patient care experience, including skilled nursing or post-acute care.
• 2+ years performing medical record audits, MDS review, or clinical reimbursement review in a payer, provider, or SNF setting, with direct experience in SNF Part A claims.
• 3+ years of supervisory or team leadership experience in a comparable production environment, or demonstrated readiness for people leadership.
• Proficiency with Microsoft Office Suite (intermediate Excel required).

Nice to have

• Experience managing or supporting remote staff
• Resident Assessment Coordinator Certified (RAC-CT or RAC-CTA) through AAPACN
• Medical coding certification (CPC, CCS, or equivalent)
• Prior experience as an MDS Coordinator, Director of Nursing, or Director of Clinical Reimbursement in a SNF
• Experience with Medicare Advantage SNF prior authorization or concurrent review
• Familiarity with SNF appeals workflows, including MAC redeterminations, and payer-provider dispute resolution processes

About the company

Machinify is a healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. It uses an AI-powered platform to maximize financial outcomes and drive down healthcare costs.