Logo for Health Services Advisory Group, Inc. (HSAG)

Health Plan Auditor I

Health Services Advisory Group, Inc. (HSAG)

Role overview

Qualifications

  • Bachelor’s degree in business, science, or healthcare-related field.
  • At least one year of work experience in healthcare (two years preferred).
  • At least one year of auditing experience.
  • Proficient English communication skills, including public speaking, spelling, grammar, proofreading and editing.

Responsibilities

  • Lead project management tasks and coordinate communications with project partners, consultants, subcontractors, and other entities on audit and performance measure validation projects, under supervision.
  • Prepare project deliverables and lead documentation/submission using electronic, hard copy, or direct data entry mechanisms, under supervision.
  • Maintain and organize project documents on SharePoint and HSAG networks; conduct literature research, primary source verification, data validation, IQC monitoring, and develop reports in Word and Excel.
  • Represent HSAG professionally, act as a liaison between management, staff, clients, and outside agencies, and contribute to quality improvement activities.

Key facts

Hard skills

Performance Management Clinical Auditing Data Validation Project Management Meeting Facilitation Tag Management Stakeholder Communications Auditing Clinical Research Data Entry Digital File Management Primary Research Quality Assessment Project Coordination Microsoft SharePoint Cross-Functional Collaboration Online Communication Organizational Structure

Other skills

  • Report Writing
  • Record Keeping
  • Quality Control
  • Microsoft Word
  • Microsoft Excel
  • Microsoft PowerPoint
  • Microsoft Outlook
  • Professionalism
  • Non-Verbal Communication
  • Public Speaking
  • Multitasking
  • Time Management
  • Detail Oriented
  • Social Skills
  • Problem Solving

About the company

Health Services Advisory Group, Inc. (HSAG) logo

Health Services Advisory Group, Inc. (HSAG)

Public Health

Health Services Advisory Group, Inc. (HSAG) is both a diversified Arizona-based quality innovation network-quality improvement organization (QIN-QIO) and an external quality review organization (EQRO). It was founded in 1979 by a group of medical professionals whose goal was to make a difference in health care quality improvement. As a QIO, HSAG works to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. As an EQRO, HSAG conducts health plan-specific reviews of quality of care, timeliness, and access to services provided to beneficiaries in managed care, behavioral health, and prepaid inpatient health plans for Medicaid programs across the country. There is a QIN-QIO representing each state within a QIN region. HSAG is the QIN-QIO for Arizona and California. At its headquarters in Arizona, HSAG has three divisions: the Federal Division, responsible for Medicare work under a federal contract; the State & Corporate Services Division, responsible for Medicaid quality review work; and the Survey, Research & Analysis Division, which offers outcomes measurement, satisfaction surveys, and quality improvement interventions. It is HSAG’s mission to be a positive force in health care by providing helpful information and quality expertise to those who deliver and those who receive health services.

Company details

Company typeSME
IndustryPublic Health
Company size201 - 500

Links

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Job description

Are you passionate about improving the quality of healthcare?
Are you ready to leverage your talents to make healthcare better for everyone?
Do you want the opportunity to give back to your community?
Do you want to have fun at work?
 
Then join the growing team at Health Services Advisory Group (HSAG) that is transforming the delivery of healthcare in the United States!

Job Details
The Auditor 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). 

    Required Education and/or Experience
  • 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.

    • Other Qualifications
  • 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.
    • Work Environment
    The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
     
    Disclaimer
    This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, work load, rush jobs requiring non-regular work hours, or technological developments).

    HSAG is an EEO Employer of Veterans protected under Section 4212.
    If you have special needs and require assistance completing our employment application process, please feel free to contact us.

    EOE M/F/Veteran/Disability

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    Marcus Rivera

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