QA Supervisor (Field Case Management)

Accountabilities:

• Review case files, reports, and billing documentation against customer-specific quality standards, program requirements, and special handling instructions.
• Maintain a strong working knowledge of customer account requirements and apply them consistently across assigned quality reviews.
• Verify billing accuracy and identify discrepancies, documentation gaps, or areas where case management services do not meet established expectations.
• Conduct regular supervisory staffing reviews to evaluate case status, quality, completeness, accuracy, and overall file integrity.
• Identify stalled, high-risk, at-risk, or non-compliant cases and communicate findings clearly to case managers and quality leadership.
• Provide specific, constructive, and development-focused feedback to help case managers strengthen documentation, service delivery, and case management practices.
• Support case managers in developing approaches that maintain file quality, compliance, and momentum.
• Escalate complex, high-risk, or significantly non-compliant cases to the appropriate quality leadership.
• Accurately document staffing notes, quality findings, improvement opportunities, follow-up actions, and review outcomes.
• Complete quality review documentation and reporting accurately and within established timelines.
• Maintain organized records of quality activities, feedback, and follow-up outcomes.
• Contribute to quality trend reporting by identifying recurring patterns and communicating insights that can support team-wide coaching and process improvements.

Requirements:

• Active Registered Nurse (RN) or Vocational Rehabilitation Specialist (VRC/CDMS) licensure is required, with licensure maintained in good standing throughout employment.
• 3+ years of field case management experience within a workers’ compensation environment.
• Prior supervisory, lead, mentoring, or coaching experience is strongly preferred.
• Experience conducting case reviews, file staffing, quality audits, compliance reviews, or working with customer-specific program standards is advantageous.
• Additional certifications such as CCM, CMC, CRRN, or CDMS are a plus.
• Strong attention to detail and a consistent quality-focused mindset.
• Excellent written and verbal communication skills, with the ability to provide clear and professional feedback.
• Ability to coach and challenge case managers constructively while maintaining positive, trusting working relationships.
• Strong organization and time-management skills, with the ability to manage multiple priorities and competing demands.
• Dependable, accountable, collaborative, and committed to continuous improvement.
• Ability to follow established procedures, interpret customer-specific standards, and escalate issues appropriately.
• Proficiency with case management systems and documentation platforms used in field case management operations.
• Comfortable using AI-enabled tools and emerging technologies to improve workflow efficiency, streamline documentation, and support quality review activities.
• Proficiency with Microsoft Office tools, including Word, Excel, and Outlook, or comparable productivity platforms.

Benefits:

• Competitive base salary of $81,500–$95,000 annually, depending on geographic market, skills, experience, education, and other relevant factors.
• Medical, dental, and vision insurance.
• Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).
• Life and AD&D insurance.
• 401(k) retirement plan.
• Tuition reimbursement.
• Additional wellness and resources designed to support long-term health and well-being.
• Benefits eligibility may vary depending on full-time or part-time status.
• Opportunity to contribute to quality improvement and professional development within a collaborative case management environment.