Supervisor, Medical Review Audit (Clinical)
MachinifyincMachinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
The Medical Review Audit Supervisor is a working supervisor who leads a remote team of clinical auditors performing medical record review, with primary oversight of Skilled Nursing Facility (SNF) audits. This role requires a licensed nurse with SNF clinical and/or reimbursement experience, command of Medicare Part A SNF coverage rules, the Patient Driven Payment Model (PDPM), and MDS 3.0 documentation, and the leadership presence to drive pe... Click Apply to read the full job description.