The Compliance and Quality Assurance Supervisor is responsible for supervising all activities and personnel associated with performing tasks and work processes assigned to the group. Actively participate as a member of the department management team and the larger organization in support of business objectives.

Essential Job Functions

Fraud Oversight

• Oversee the review and documentation of potential fraud, waste, and abuse concerns.
• Ensure cases are tracked, reviewed, and closed within required timeframes.
• Assist with gathering information for reports or follow-up requests from internal teams or external agencies.
• Identify patterns and bring forward trends or issues for review.
• Handle the research of PA and MA Grievances Inboxes, providing information to Compliance Manager.
• Coordinate the MA Grievance Semi Annual spreadsheets for submission to MassHealth (Jan and July).
• Develop, measure, and report meaningful key metrics.
• Identify, design, and implement process improvements.

Records Request Management

• Supervise processing of records, medical records, subpoenas, authorizations, and general information requests.
• Make sure requests are handled accurately, securely, and within required turnaround times.
• Serve as the escalation point for complex or urgent requests.
• Maintain tracking logs and ensure proper documentation.

Supervisory Responsibilities

• Provide daily supervision, coaching, and guidance to assigned staff.
• Assign and monitor workload to ensure service standards are met.
• Support training, onboarding, and ongoing development or team members.
• Conduct performance reviews and support corrective action when needed.

• Coordinate with other functions in payroll & billing to streamline workflows/handoffs.
• Lead department meetings.
• Supporting other department functions as necessary.
• Perform other duties as assigned.

Compliance & Reporting

• Maintain organized documentation to support audits and internal reviews.
• Prepare regular reports on fraud cases, record requests, and FI activity.
• Assist with internal compliance projects and workflow improvements.
• Participate in internal reviews, privacy matters, and follow-up actions as needed.

Other

• Support overall mission and objectives of Tempus Unlimited
• Must report all suspected incidents of consumer sexual abuse, physical abuse and neglect to the Disabled Person Protection Commission (D.P.P.C.).

Requirements

• Ability to supervise and direct staff
• Excellent organizational skills
• Attention to accuracy and detail
• Strong interpersonal skills – telephone skills
• Excellent oral and written communication
• Good computer and analytical skills
• Innovative thinking

Travel

• Travel to company sites and agencies as required.

Other Skills/Abilities

• Familiarity with Fraud functions & PCA program procedures and regulations
• Ability to maintain confidentiality

Required Education and Experience

• High School Diploma
• Experience working with confidential information.
• Strong attention to detail and accuracy.
• Ability to communicate clearly and professionally.
• Basic proficiency with Microsoft Office (Word, Excel, Outlook).

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers and scanners.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk and/or hear. The employee is frequently required to sit; stand; walk; use hands and fingers and also must be able to reach with hands and arms. Must be able to lift up to 15 pounds at times.

Other Duties

Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Benefits

Tempus Unlimited offers great benefits that foster a happy fulfilling human work experience. We also have an array of growth opportunities for our employees to develop your career and enhance your experience.

• Sign on bonus
• Work/Life Balance
• Paid time off - 25 days per year for full time staff
• 14 paid Holidays
• Tempus Wellness - Medical, Dental, Dependent Care Reimbursement, FSA and HSA
• Basic Life, Short Term and Long-Term Disability
• On-site gym (Stoughton Location) and wellness initiatives
• Annual Reviews with merit-based increases
• Employee Recognition Program
• Financial Wellness - 403(b) Retirement Plan with matching
• Continuing Education, Training and Advancement opportunities

Work Authorization/Security Clearance

All offers of employment made by Tempus Unlimited are contingent upon satisfactory background check results. Pre-employment background checks will be conducted on all candidates that are offered a position at the agency in compliance with program policy as well as state and federal regulations. From time to time, these checks may be conducted on current employees to ensure compliance with all state and federal regulations and contracts.

EEO Statement

Equal Employment Opportunity is a fundamental principle at Tempus Unlimited, Inc. where employment from recruiting through the end of employment is based upon professional capabilities and qualifications without discrimination because of race, color, religion, sex, age, sexual orientation, veteran status, national origin, disability or any other characteristic as established by law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.