Director, Audits – Healthcare

🕒 il y a 17 jours

🇺🇸 États-Unis – Télétravail

💵 $133 000 - $160 000 / an

⏰ Temps Plein

🔴 Expert

👔 Directeur

👻 Score fantôme 0%

Ce que ça veut dire : la probabilité que personne ne recrute vraiment pour cette offre.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

Postuler Maintenant

Trouver des Emplois à Distance Similaires

Health Services Advisory Group, Inc. (HSAG)

Site WebLinkedInTous les Emplois

201 - 500 employés

Fondée en 1979

🏥 Santé

⚕️ Assurance santé

🏛️ Gouvernement

Healthcare • Healthcare Insurance • Government

Health Services Advisory Group, Inc. (HSAG) est une organisation axée sur sa mission d'amélioration de la qualité des soins de santé, qui collabore avec des agences fédérales et étatiques, des régimes de santé et des prestataires pour améliorer la prestation des soins et les résultats pour les patients. HSAG fournit des services de science des données et d'analytique avancée, d'administration d'enquêtes, d'examen de cas de dossiers médicaux, d'audits et de conseil en santé pour soutenir les programmes de qualité de Medicare et Medicaid, les évaluations des dérogations, les initiatives de santé rénale et les enquêtes nationales auprès des patients. L'organisation se concentre sur le respect des réglementations, la mesure des performances et l'amélioration de la qualité basée sur des preuves pour obtenir de meilleurs résultats dans l'ensemble du continuum des soins de santé.

Description

• Serve as the team leader on the PMV and HEDIS teams and senior leader within HSAG’s Medicaid Services division • Provide operational oversight of PMV and HEDIS audit activities • Act as a liaison between HSAG and state Medicaid agencies and organizations • Direct project planning, implementation, and performance monitoring across scope, staffing, schedules, budgets, and deliverables • Lead and coach auditors and assigned staff by setting expectations, monitoring performance, supporting development, and fostering accountability and collaboration • Ensure customer deliverables are accurate, high quality, internally reviewed and approved, and submitted on time • Leverage SharePoint and Copilot to streamline workflows and improve deliverable production • Monitor financial performance, including staffing plans, labor utilization, budgets, and forecasts • Identify and mitigate operational, contractual, staffing, and customer risks; escalate significant concerns to the Senior Executive Director • Participate in oversight of analytic output from partnering divisions • Develop and adhere to analytic project time and task schedules; identify process improvements and develop quality improvement activities • Conduct Internal Quality Control monitoring; present issues and recommended solutions and take corrective actions • Assist in contracting, including development and review of contract language, scopes of work, and budgeting • Define appropriate audit approaches • Present and communicate project results to nonanalytic staff members and customers • Lead responses to requests for proposals (RFPs) • Implement formal training series for junior and senior staff

🎯 Exigences

• Bachelor’s degree or equivalent work experience in Medicaid managed care, HEDIS, performance measures, and/or audits • Credentialed as an NCQA Certified HEDIS Compliance Auditor (CHCA) or proficiency in HEDIS reporting • At least fifteen (15) years of work experience • At least ten (10) years of healthcare experience, preferably Medicaid • Budget and cost proposal development experience, including leading cost proposal development • Contract development and review experience • Expertise in Medicaid, health plan operations, or managed care • Expertise in evaluating medical and prescription drug claims and encounters; eligibility and enrollment; demographic; survey; and vital statistics data required • Experience evaluating electronic health record and clinical data preferred • Experience mentoring multiple staff • Demonstrated ability to supervise a team including responsibility for monitoring and evaluating performance • Excellent English/communication skills (i.e., spelling, composition, grammar, proofreading and editing) • Strong public speaking skills • Excellent interpersonal skills • Proficient in Microsoft Word, PowerPoint, Excel, Outlook and Copilot • Ability to lead several large projects simultaneously and lead multiple analytic teams working on disparate activities

🏖️ Avantages

• A comfortable work-life balance, including flexible work schedules • Three weeks of paid time off • 13 company-paid holidays • Staff leave two hours early prior to each holiday • Medical insurance • Dental insurance • Vision insurance • Tuition reimbursement • 401(k) • Employee stock ownership plan

📊 Vérifiez votre score de CV pour ce poste

Améliorez vos chances d'obtenir un entretien en vérifiant votre score de CV avant de postuler.

Télécharger le CV