Quality Assurance Manager
Remote · USFull-time$85–115K/yrSeen 4w agoSeen in employer's feed 1w ago
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At a glance
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Job overview
The Quality Assurance Manager oversees quality assurance activities for the Audit and Reimbursement department, serving as a subject matter expert in Medicare reimbursement and cost reporting. The role supports risk assessment, regulatory interpretation, and continuous improvement, and ensures adherence to CMS regulations. The position is open to remote work in specified states and offers a stated salary range of $85,000 to $115,000.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
Job Duties
Description
Our Quality Assurance Manager coordinates and oversees the continued development, implementation, and monitoring of the Quality Assurance activities for the Audit and Reimbursement department. They serve as a subject matter expert in Medicare reimbursement and cost reporting, provide technical leadership, monitor quality through periodic reviews, and facilitate ongoing development and implementation of the Quality Assurance process. This QA Manager ensures adherence to the regulations of the Centers for Medicare and Medicaid Services (CMS). They play a critical role in risk assessment, Medicare regulation interpretation, and continuous improvement initiatives that support responsible stewardship of Medicare funds.
Salary Range $85,000 ~ $115,000
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, experience, and may fall outside of this pay range.
Work Location
We are open to remote work in the following approved states:
Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin
How do I know this opportunity is right for me? If you:
Enjoy consulting with Management in facilitating the development and implementation of Quality Assurance activities as well as consistency monitoring within Medicare Audit and Reimbursement.
Like to research and respond to issues by developing rebuttals for each issue found during the annual Quality Assurance Surveillance Plan (QASP) reviews completed for Medicare Administrative Contractor (MAC)contracts (J5 and J8).
Can respond to audit staff on various audit research issues, perform tertiary review for Nursing and Allied Health (NAH) provider operated programs, and review Organ Acquisition audit scoping.
Have conducted Internal Quality Control (IQC) reviews and issued an IQC report to Medicare Audit and Reimbursement Management.
Would like to conduct quarterly meetings with Medicare Audit and Reimbursement Management and Field Audit Supervisors and staff to discuss IQC findings.
Want to Complete quarterly Reopening and Appeals Reviews ensuring compliance with Medicare regulations.
Have reviewed and approved forms that are created or revised ensuring the forms are accurate and properly tested.
Can respond timely and accurately to provider inquiries and inquiries from other internal and external customers.
Like to interpret and apply CMS regulations, Medicare reimbursement principles, and Government Auditing Standards to complex scenarios.
Can lead or participate in work groups, special projects, regulatory implementation initiatives, and cross-functional collaborations focused on improving work paper guidelines, auditing techniques, and documentation standards.
Minimum Qualifications
Bachelor's degree in Accounting, Finance, Business Administration, or related field, or equivalent post high school education and/or work-related experience.
5 or more years of progressive experience in Medicare auditing and/or Reimbursement activity.
Extensive, thorough knowledge of auditing techniques, practices and issues, Government Auditing Standards and Medicare rules and regulations.
Thorough knowledge and understanding of claims processing and pricing and the Provider Statistical and Reimbursement Report (PS&R).
Excellent researching skills and understanding of the types and hierarchy of authoritative sources.
Demonstrated expertise in complex reimbursement methodologies and cost allocation principles.
Proven analytical, decision making and judgment abilities.
Demonstrated skill in group facilitation, project management, data analysis, and risk assessment.
Strong skills with professional, technical written and verbal communications.
Preferred Qualifications
7 or more years of progressive experience in Medicare auditing and/or Reimbursement activity.
Significant experience with audit methodologies, financial analysis, and regulatory compliance.
A strong affinity to technical documentation and healthcare writing.
Remote Work Requirements
Wired (ethernet cable) internet connection from your router to your computer.
High speed cable or fiber
Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net).
Please review Remote Worker FAQs for additional information.
Benefits
Remote work options available
Performance bonus and/or merit increase opportunities
401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
Competitive paid time off
Health insurance, dental insurance, and telehealth services start DAY 1
Professional and Leadership Development Programs
Review additional benefits: (https://www.wpshealthsolutions.com/careers/)
Who We Are
WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.
Culture Drives Our Success
WPS' culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.
We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.
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WPS Health BlogThis position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation including fingerprinting prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer.
Minimum Education Required
High School Diploma or Equivalent
Minimum Experience Required
5 - 20 years
Shift
First (Day)
Number of Openings
1
Public Transportation Accessible
Yes
Veterans Encouraged to Apply
No
Physical Required
Yes
Drug Test Required
Yes
Compensation
$11.41 / Hourly
Postal Code
55407
Job Type
Full Time
Place of Work
On-site
Requisition ID
QUALI006174
Job Benefits
Not specified
How this job compares
Set against the 431 open Quality Assurance Manager jobs on Olive Jobs, counted November 4, 2026.
- Pay
- This posting$85–115K/yr
- US median$91–140K/yr291 salary ranges
This range's midpoint, $100K, is 18% below the US median midpoint ($123K) — in the middle half of Quality Assurance Manager salary ranges across the US.
- Openings
- Olive Jobs lists 10 open Quality Assurance Manager jobs in Minnesota and 431 across the US. 4% of them nationwide are listed as remote or flexible.
- Experience
- This posting asks for at least 5 years of experience; Quality Assurance Manager postings that state a minimum ask for 5 years at the median (294 postings).
- Education
- 112 of the 431 open Quality Assurance Manager jobs (26%) ask for a bachelor's degree or higher.
Counted across the open, public US postings on Olive Jobs on November 4, 2026. Pay medians are the middle values of the low ends and of the high ends of postings that list both ends of a range in the same cadence (a yearly salary or an hourly rate); a range's midpoint is halfway between its ends. Pay and experience figures resting on fewer than 20 postings are left out.
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