Supervisor

• Support corporate-wide safety activities
• Direct and support performance improvement initiatives
• Promote and maintain a culture of safety at all PMS facilities
• Assure compliance with accreditation standards
• Work with PMS management and Continuous Accreditation Readiness Teams
• Provide safety and accreditation oversight for a nonprofit healthcare organization serving underserved areas of New Mexico

Safety & Accreditation Supervisor

• Supervise, coach, and develop a team of Medicaid claims processors, analysts, and support staff
• Monitor daily claims processing activities to ensure timely, accurate, and compliant adjudication of Medicaid claims
• Manage escalated claims issues, Tier 3 claims escalations, payment discrepancies, provider concerns, and operational exceptions
• Ensure achievement of service level agreements, key performance indicators, quality standards, and contractual requirements
• Review operational reports and performance metrics to identify trends, risks, and improvement opportunities
• Investigate and resolve escalated claims issues, payment discrepancies, and provider inquiries
• Support quality assurance activities, audits, corrective action plans, and process improvement initiatives
• Ensure compliance with CMS regulations, state Medicaid policies, HIPAA requirements, and operating procedures
• Coordinate with internal departments, state agencies, providers, and client stakeholders to resolve operational issues
• Support workforce planning, scheduling, training, and employee development activities
• Maintain documentation, operational procedures, and workflow standards
• Participate in system enhancements, testing activities, and special projects

Supervisor jobs in New Mexico

Safety & Accreditation Supervisor

Medicaid Claims Supervisor