Health Plan Auditor I- II - REMOTE

  • Health Services Advisory Group, Inc.
  • Columbus, Ohio
  • Full Time

Job DetailsThe Auditor I is a contributor to the Audits department's work that spans the broad spectrum of healthcare performance measurement projects at HSAG. Driven by intellectual curiosity and a passion for healthcare quality, this position performs-under supervision-healthcare auditing, data validation, and performance measurement projects through various stages including implementation, day-to-day operations, audit support, evaluation, and reporting. Activities include developing work plans and timelines; overseeing project tasks; guiding coordination staff in oversight and maintenance of project files; leading client teleconferences and meetings; performing online research on healthcare topics; leading primary source verification; validating performance results and outcomes; and providing regular progress reports to Data Science & Advanced Analytics management staff.Details regarding potential project assignments will be discussed with potential candidates during the interview process.Essential Competencies, Duties and Responsibilities* 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)[1]measures and non-HEDIS performance measures as applicable.* Represent HSAG in a professional manner at all times.[1]HEDIS Certified Measures is a registered trademark of the National Committee for Quality Assurance (NCQA).Compensation: 65000 - 75000 DOEJob Requirements:Education and/or Experience* Bachelor's degree in business, science, or healthcare-related field.* A minimum of 1 year of experience working with health care provider data is required.* Experience with managed care provider network adequacy monitoring and/or reporting is preferred.Other Qualifications* Proficient English/communication skills (i.e., public speaking, spelling, composition, grammar, proofreading andApply here:

Job ID: 470605943
Originally Posted on: 3/25/2025

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