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Healthcare Auditor II

Role overview

Qualifications

  • Bachelor’s degree in business, science, or healthcare-related field
  • At least three years of work experience in healthcare
  • At least two years of auditing experience and one year as a lead auditor
  • Knowledge of performance measures

Responsibilities

  • Assist in the management of client contracts and lead small projects
  • Lead non-HEDIS performance measure validation audits
  • Conduct online research on healthcare topics and perform Internal Quality Control monitoring
  • Prepare project deliverables and communicate with project partners under limited supervision

Key facts

Other skills

  • Research
  • Report Writing
  • Microsoft PowerPoint
  • Microsoft Outlook
  • Social Skills
  • Communication
  • Teamwork
  • Time Management
  • 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

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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!

Summary
 
HSAG is nationally recognized as an industry leader in the areas of audits, data analysis, measure development, and patient satisfaction surveys. We are in search of talented individuals who are interested in a career in healthcare performance measure auditing as an Auditor II in HSAG’s Audits department within the Data Science & Advanced Analytics division. Together we can spread positive change to make healthcare better.  
 
UNIQUE BENEFITS
 
The Auditor II position benefits from HSAG’s desire to grow its staff into future leaders of healthcare quality improvement in the nation. HSAG’s auditors are provided formal training in an assortment of healthcare-related topics, including health policy, clinical concepts, overview of analytic methods, data sources, and management techniques. 
 
HSAG offers:
·         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). 
 
DESCRIPTION
 
The Auditor II is a key 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 limited supervision—healthcare auditing, data validation, and performance measurement projects through various stages including implementation, day-to-day operations, auditing, evaluation, and reporting. Activities include developing and managing work plans and timelines; leading targeted projects and tasks; guiding coordination and Auditor I staff in oversight and maintenance of project files and other project tasks; leading client teleconferences and meetings; performing online research on healthcare topics; leading performance measure validation audits; 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 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®)[1]
  • 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.
  • [1]HEDIS Certified Measures® is a registered trademark of the National Committee for Quality Assurance (NCQA).audit operations.

    Education and/or Experience
  • 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.

  • 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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    m.rivera@company.com
    linkedin.com/in/marcusrivera
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