Healthcare Auditor II

🕒 April 29

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Health Services Advisory Group, Inc. (HSAG)

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1979

⚕️ Healthcare Insurance

🏛️ Government

Healthcare Insurance • Government

Health Services Advisory Group, Inc. (HSAG) is a mission-driven healthcare quality improvement organization that partners with federal and state agencies, health plans, and providers to improve care delivery and patient outcomes. HSAG provides data science and advanced analytics, survey administration, medical record case review, audits, and healthcare consulting services to support Medicare and Medicaid quality programs, waiver evaluations, kidney health initiatives, and national patient surveys. The organization focuses on regulatory compliance, performance measurement, and evidence-based quality improvement to drive better outcomes across the healthcare continuum.

📋 Description

• Serve as a key member of HSAG’s Audits department within DSAA. • Assist in the management of client contracts and lead small projects and tasks. • Assist in the management of supplemental Healthcare Effectiveness Data and Information Set(HEDIS®). • Serve as a lead auditor for non-HEDIS performance measure validation audits. • Act in a liaison capacity between appropriate management personnel and staff, transmitting decisions and information to organizational units as appropriate, as well as outside agencies and organizations, under limited supervision. • Lead project management tasks, including communication (written, phone, fax), under limited supervision. • Communicate with project partners, consultants, subcontractors, and other entities on audit and performance measure validation-related projects, under limited supervision. • Maintain, tag, and sort documents for assigned projects on appropriate SharePoint team sites and HSAG’s corporate and federal networks following HSAG prescribed governance rules. • Prepare project deliverables and lead documentation and submission of deliverable using the appropriate mechanism (i.e., electronic, hard copy, direct data entry etc.), under limited supervision. • Develop and adhere to project time and task schedules, identify opportunities to improve the project process, and develop quality improvement activities accordingly. • Meet agreed-upon deadlines in a timely fashion and accurately prepare and type deliverables, reports, various project documents, letters, and other material with limited supervision. • Develop and prepare written and data-oriented reports in Microsoft Word and Excel, under limited supervision. Serve as a major report contributor. • Conduct research via the Internet including literature searches of clinical topics as assigned. • Participate in pertinent healthcare educational and training presentations as required. • Conduct Internal Quality Control (IQC) monitoring regarding efficiency/effectiveness of activities conducted. Present issues and recommended solutions and take corrective actions as indicated. • Serve as a key reference to HSAG staff and clients on HEDIS measures and non-HEDIS performance measures as applicable. • Represent HSAG in a professional manner at all times.

🎯 Requirements

• Bachelor’s degree in business, science, or healthcare-related field. Master’s degree is preferred. • At least three years of work experience in healthcare and a minimum of five years of work experience are required. • At least two years of auditing experience and one year of experience as a lead auditor, with at least one year in HEDIS auditing and/or data validation. • Knowledge of performance measures is required. • Experience writing client reports is required. • Contract management and/or project management experience is required.

🏖️ Benefits

• A comfortable work-life balance, including flexible work schedules. • Three weeks of paid time off and 15 company-paid holidays where staff leave two hours early prior to each holiday to get a“jump start” on holiday festivities. • HSAG offers a competitive benefit package which includes medical, dental, vision, tuition reimbursement, and 401(k).