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Health Plan Auditor I

11 hours, 12 minutes ago
Anywhere
Full-time
Junior
QA Engineer
Data Science and Analytics
Apply Now
Health Services Advisory Group

Health Services Advisory Group

HSAG is a quality improvement organization that enhances healthcare quality for Medicare and Medicaid beneficiaries through reviews and interventions.

Health Care Providers & Services
251-1K
Founded 1979
View All Jobs 5

Description

  • Perform healthcare auditing, data validation, and performance measurement projects through implementation, operations, audit support, evaluation, and reporting stages.
  • Develop project work plans and timelines and adhere to project time and task schedules.
  • Oversee project tasks and guide coordination staff in oversight and maintenance of project files.
  • Lead client teleconferences and meetings and communicate with project partners, consultants, subcontractors, and other entities on audit and validation-related work, under supervision.
  • Maintain, tag, and sort project documents on SharePoint and HSAG networks following governance rules.
  • Prepare, document, and submit project deliverables through appropriate mechanisms (electronic, hard copy, direct data entry), under supervision.
  • Validate performance results and outcomes, lead primary source verification, and provide regular progress reports to DSAA management staff.
  • Support development of written and data-oriented reports and other project materials using Microsoft Word and Excel.
  • Conduct internet research including literature searches of clinical topics and present issues with recommended solutions; take corrective actions as indicated.
  • Conduct Internal Quality Control (IQC) monitoring to assess efficiency/effectiveness and identify opportunities for quality improvement.

Requirements

  • Bachelor’s degree in business, science, or a healthcare-related field.
  • At least 1 year of work experience in healthcare required; 2 years preferred.
  • At least 1 year of auditing experience required.
  • Proficient English communication skills, including public speaking, writing (spelling, composition, grammar), proofreading, and editing.
  • Proficient interpersonal skills and ability to work with multiple teams.
  • Experience with Microsoft Word, PowerPoint, Outlook, and Excel.
  • Experience conducting research via the Internet, including literature searches of clinical topics.
  • Ability to manage multiple projects simultaneously and meet agreed-upon deadlines.

Benefits

  • Salary range $62,000 - $70,000 per year.
  • Remote work (position listed as remote).
  • Opportunity to participate in healthcare educational and training presentations (professional development).
  • Inclusive employer (HSAG is an EEO Employer) and reasonable accommodations for applicants/employees.
  • Opportunity to give back to the community and a culture that emphasizes engagement and enjoyment at work.

Interested in this position?

Apply directly on the company website

Apply Now

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