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Health Plan Auditor I- II - REMOTE - 985/668/3752_43067705237_0-3819
Health Plan Auditor I- II - REMOTE - 985/668/3752_43067705237_0-3819-January 2024
Phoenix
Jan 26, 2025
About Health Plan Auditor I- II - REMOTE - 985/668/3752_43067705237_0-3819

  This job was posted by https://www.azjobconnection.gov : For moreinformation, please see: https://www.azjobconnection.gov/jobs/6306482Job Details

  The Auditor I is a contributor to the Audits department\'s work thatspans the broad spectrum of healthcare performance measurement projectsat HSAG. Driven by intellectual curiosity and a passion for healthcarequality, this position performs-under supervision-healthcare auditing,data validation, and performance measurement projects through variousstages including implementation, day-to-day operations, audit support,evaluation, and reporting. Activities include developing work plans andtimelines; overseeing project tasks; guiding coordination staff inoversight and maintenance of project files; leading clientteleconferences and meetings; performing online research on healthcaretopics; leading primary source verification; validating performanceresults and outcomes; and providing regular progress reports to DataScience & Advanced Analytics management staff.

  Details regarding potential project assignments will be discussed withpotential candidates during the interview process.

  Essential Competencies, Duties and Responsibilities

  Serve as a contributing member of HSAG\'s Audits department withinDSAA.

  Act in a liaison capacity between appropriate management personneland staff, transmitting decisions and information to organizationalunits 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, andother entities on audit and performance measure validation-relatedprojects, under supervision.

  Maintain, tag, and sort documents for assigned projects onappropriate SharePoint team sites and HSAG\'s corporate and federalnetworks following HSAG prescribed governance rules.

  Prepare project deliverables and lead documentation and submissionof 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, identifyopportunities to improve the project process, and develop qualityimprovement activities accordingly.

  Meet agreed-upon deadlines in a timely fashion and accuratelyprepare and type deliverables, reports, various project documents,letters, and other material from copy, rough draft, or otherprescribed instructions.

  Support development of written and data-oriented reports inMicrosoft Word and Excel, under supervision.

  Conduct research via the Internet including literature searches ofclinical topics as assigned.

  Participate in pertinent healthcare educational and trainingpresentations as required.

  Conduct Internal Quality Control (IQC) monitoring regardingefficiency/effectiveness of activities conducted. Present issues andrecommended solutions and take corrective actions as indicated.

  Serve as a reference to HSAG staff and clients on HealthcareEffectiveness 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 NationalCommittee for Quality Assurance (NCQA). Compensation: 65000 - 75000 DOE

  Job Requirements:

  Education and/or Experience

  Bachelor\'s degree in business, science, or healthcare-relatedfield.A minimum of 1 year of experience working with health care providerdata is required.Experience with managed care provider network adequacy monitoringand/or reporting is preferred.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 withmultiple teams.Work Environment

  The work environment characteristics described here are representativeof those an employee encounters while performing the essential functionsof this position

  Reasonable accommodations may be made to enable individuals withdisabilities to perform the essential functions.

  Disclaimer

  This is not necessarily an exhaustive list of all responsibilities,skills, duties, requirements, efforts or working conditions associatedwith the position

  While this is intended to be an accurate reflection of the currentposition, management reserves the right to revise the position or torequire that other or different tasks be performed when circumstanceschange (e.g., emergencies, changes in personnel, work load, rush jobsrequiring non-regular work hours, or technological developments).

  HSAG is an EEO Employer of Veterans protected under Section

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