Health Plan Auditor I

🕒 vor 2 Monaten

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Health Services Advisory Group, Inc. (HSAG)

WebsiteLinkedInAlle Stellen

201 - 500 Mitarbeiter

Gegründet 1979

⚕️ Krankenversicherung

🏛️ Regierung

Healthcare Insurance • Government

Die Health Services Advisory Group, Inc. (HSAG) ist eine zielorientierte Organisation zur Verbesserung der Qualität im Gesundheitswesen, die mit Bundes- und Landesbehörden, Krankenversicherungen und Anbietern zusammenarbeitet, um die Betreuung und die Ergebnisse für Patienten zu verbessern. HSAG bietet Datenwissenschaft und fortgeschrittene Analysen, Verwaltung von Umfragen, Überprüfung von Krankenakten, Audits und Beratungsdienstleistungen im Gesundheitswesen an, um die Qualitätsprogramme von Medicare und Medicaid, die Bewertung von Ausnahmeregelungen, Initiativen zur Nierengesundheit und nationale Patientenbefragungen zu unterstützen. Die Organisation konzentriert sich auf die Einhaltung von Vorschriften, Leistungsbewertung und evidenzbasierte Qualitätsverbesserung, um bessere Ergebnisse über das gesamte Gesundheitswesen hinweg zu erzielen.

Beschreibung

• Serve as a contributing member of HSAG’s Audits department within DSAA. • 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 supervision. • Lead project management tasks, including communication (written, phone, fax), under supervision. • Communicate with project partners, consultants, subcontractors, and other entities on audit and performance measure validation-related projects, under 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 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 from copy, rough draft, or other prescribed instructions. • Support development of written and data-oriented reports in Microsoft Word and Excel, under supervision. • 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 reference to HSAG staff and clients on Healthcare Effectiveness Data and Information Set (HEDIS®) measures and non-HEDIS performance measures as applicable. • Represent HSAG in a professional manner at all times.

🎯 Anforderungen

• Bachelor’s degree in business, science, or healthcare-related field. • At least one year of work experience in healthcare is required; two years of work experience in healthcare is preferred. • At least one year of auditing experience is required. • Proficient English/communication skills (i.e., public speaking, spelling, composition, grammar, proofreading and editing). • Proficient interpersonal skills. • Experience in Microsoft Word, PowerPoint, and Outlook. • Experience in Microsoft Excel. • Experience in conducting research via the Internet. • Ability to handle several projects simultaneously and work with multiple teams.