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Supervisor, Clinical Compliance (RN) – Remote
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. Join us as we put healthcare on a better path!!
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.
- 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. ALIVE with Purpose: How We Thrive at Guidehealth At Guidehealth, our values come to life in everything we do.- We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike.
- Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare.
- With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve.
- At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member.
- And through Empathy in Action, we build stronger connections with those who count on us.
- This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.
- 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.