Supv Provider Audit

• Position is Eligible for Remote / Work from Home Opportunity*

• Position is Eligible for Remote / Work from Home Opportunity*

Department: Provider Audit

Telecommuting Eligible:
Yes

Job Grade: E13

As a condition of employment, physical work location must be in one of the 50 states or the District of Columbia.

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Supervisor Provider Audit

The Supervisor Provider Audit is responsible for leading and development the Centers for Medicare & Medicaid Services (CMS) provider audit and reimbursement employees to ensure the team is administering the organization's contract with the best possible service while maintaining contract expectations and performance metrics within the budget and time constraints.

• Meets contractual obligations and performance standards, while ensuring quality performance through the performance management of staff and implementing internal controls
• Prioritizes and delegates workload for direct reports, ensuring workflow is monitored and adjusted as needed to ensure workloads are completed in a timely manner based on internal and external standards
• Coaches and develops staff by encouraging growth to ensure staff are meeting expectations
• Initiates disciplinary action when performance does not meet expectations and documents and follows up with disciplinary plans, conversations, and decisions appropriately
• Provides ideas and initiates innovation in areas of process improvements and technology enhancements
• Leads by example by promoting teamwork, recognition, and leadership while demonstrating company values
• Responds to and implements change in a flexible, positive manner
• Participates as the area Subject Matter Expert (SME) and resources for internal and external customers, which may include CMS, government officials, provider representatives, and other various contractors
• Serves as a resource point for internal and external customers including CMS and various contractors
• Participates in budget process for area
• Provides analytical and broad-based view of systems by acquiring and maintaining a thorough knowledge of all systems and subsystems used to administer the Medicare program and other lines of business
• May conduct reviews of all departmental activities, including in-depth analysis of complex reimbursement structures identified in the Medicare cost report which are in accordance with CMS and the Code of Federal Regulations

• Other duties as assigned

• Bachelor's degree in Accounting, Business, Finance, OR equivalent work experience
• 5 years' Medicare auditing experience
• Advanced knowledge of Medicare reimbursement principles and regulations and Medicare Cost Report
• Advanced knowledge of accounting theory and practices
• Proficient in Medicare/Medicaid regulations, healthcare terminology, and various software packages and applications
• Demonstrated an understanding of industry and enterprise objectives
• Strong verbal and written communication skills
• Ability to build effective interpersonal relationships within the workplace
• Ability to motivate and manage a large group of people
• Ability to direct and maintain a productive and dynamic working environment
• Ability to coordinate activities among team
• Ability to problem solve and develop problem solving skills within staff

Above requirements and the following:

• 3 years' experience in leadership
• Expertise in working with the STAR database
• Ability to create and conduct presentations
• Strong PC skills, including advanced knowledge in Microsoft Office applications (Work, Excel, Outlook, PowerPoint etc.)
• Excellent organization skills
• Strong analytical skills and attention to detail
• Experience in technical or medical applications
• Experience in large scale project management

• Office Environment
• Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
• Requires prolonged sitting and telephone use
• Requires the use of office equipment such as computer terminals, telephones, copiers, and printers
• Infrequent lifting to 15 pounds
• Infrequent stooping
• Travel up to 25%

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to:
Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the…