Supervisor, Clinical Compliance (RN) - Remote

Guidehealth•Rockford, IL

17h•$85,000 - $90,000•Remote

About The Position

Guidehealth is 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.

Requirements

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.

Nice To Haves

Claims processing experience
Coding certificates are a plus

Responsibilities

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.