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Search for Jobs by Deana Rodriguez

Audit Specialist - Healthcare (Healthcare & Medical)
Phoenix, AZ 85016
Recruited by: Deana Rodriguez | Recruiter | Health Services Advisory Group, Inc. See all my Jobs

  • Hiring Company: HSAG
  • Industry: Healthcare & Medical
  • Compensation: to be determined
  • Expires: Apr 06, 2019
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Job Description




DESCRIPTION

With direction, assist the Director in various tasks related to performance measure validation audits and related project management activities. Primary responsibilities include audit related activities such as document review, project management, analysis and tracking, reports. Additional responsibilities include assisting lead auditors with pre-onsite, onsite, and post-onsite audit activities as directed. Assist to complete audit related documentation by documenting audit results and findings. Assist with report writing and report validation. Responsibilities include but are not limited to other project activities such as project planning; meeting project timelines, rate review and project deliverables. Work with team members, including project coordinators, project support staff, and management.

ESSENTIAL COMPETENCIES, DUTIES AND RESPONSIBILITIES

Conduct desk review of documents received from health plans or similar organizations to prepare for audits. Prepare notes to assist the lead auditor in conducting the audit.
Detail oriented to ensure accuracy of all assigned tasks, including documentation and validation of data analysis. Identify problem areas and propose effective solutions.
Responsible for generating reports supported by tables, charts, graphs, and text as applicable.
Coordinate and participate in pre-onsite audit activity including updating and disseminating audit documentation to health plans and medical groups, preliminary audit documentation tracking and review, follow-up with health plans and medical groups.
Able to participate in a variety of onsite audit tasks including interview of staff, review of medical claims and encounter data processing systems and a review of performance measure rates.
Ability to understand measure specifications and technical data and provide guidance to internal and external clients.
Ability to evaluate and measure rate changes and explain data trends.
Coordinate and participate in post-onsite audit activity including documentation request follow-up, preliminary and final report writing, and performance measure rate review and benchmarking. Validation.
Develop and adhere to project timelines and task schedules, and identify opportunities to improve the processes.
Participate in educational presentations as required.
Assist in the development of training and the provision of technical assistance to clients and other HSAG staff members as needed.
Attend and participate in team, project, staff, and training meetings.
Ability to make presentations and communicate project results.
Represent HSAG in a professional manner at all times.

EDUCATION AND/OR EXPERIENCE

Minimum Bachelor’s degree required. Preferred in a health care-related field such as public health, business, economics, math, or statistics.
Minimum of two years’ working experience in healthcare and/or with state Medicaid requirements or managed care plans.
Minimum of two years’ project management experience.


OTHER QUALIFICATIONS

Proficient in Microsoft Word, Excel, Outlook, and PowerPoint.
Excellent oral and written communication and interpersonal skills.
Technical writing experience preferred.
Ability to travel to conduct audits in and out of state.

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 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/Disability/Veteran