Machinify
Machinify 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 Supervisor, Operations Quality is responsible for overseeing the day-to-day execution of quality assurance programs across operational departments such as Customer Service, Correspondence, Operations Support, and Repricing. This role ensures consistent application of quality standards, supports QA staff development, and drives adherence to audit processes, calibration standards, and performance expectations.
Key Responsibilities
- Supervise daily activities of QA specialists across multiple operational areas
- Ensure consistent execution of QA audits, scorecards, and monitoring processes
- Review completed audits for accuracy and consistency
- Conduct calibration sessions to ensure scoring alignment
- Provide coaching, feedback, and performance management
- Monitor QA productivity and turnaround times
- Identify trends and support corrective actions
- Ensure compliance with HIPAA, CMS, and internal policies
- Escalation management and issue resolution
- Support for training initiatives and documentation maintenance
- KPI monitoring and operational reporting support
- Partnership with operational leadership teams across departments
Knowledge, Skills, and Abilities Needed
- Strong understanding of healthcare operations and payment integrity
- Knowledge of QA methodologies and audit processes
- Coaching and leadership skills
- Strong analytical and communication skills
- High attention to detail
Required and Preferred Qualifications
- Bachelor’s degree or equivalent experience
- 3–5 years QA or healthcare operations experience
- Supervisory experience preferred
- Familiarity with HIPAA and CMS guidelines, and healthcare compliance standards
- Experience with call monitoring systems, document intake handling, printing technology, and file management
Equal Employment Opportunity at Machinify
Originally posted on Himalayas
To apply for this job please visit himalayas.app.
Working in United States
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