Senior Auditor (Healthcare)

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 The Senior Auditor conducts complex healthcare performance measure validation (PMV) activities. This position applies Healthcare Effectiveness Data and Information Set ® (HEDIS) Compliance Audit principles, techniques, and professional judgment to the validation of HEDIS and non-HEDIS performance measures in accordance with applicable technical specifications, contractual requirements, and the Centers for Medicare/Medicaid Services (CMS) External Quality Review (EQR) Protocol 2. The Senior Auditor evaluates information systems, data integrity, measure calculation processes, source code and programming logic, medical record review processes, and reported performance measure results to determine whether measures are accurate, reliable, and calculated in accordance with established specifications. The Senior Auditor will have the ability to work independently while providing technical leadership and mentoring to other staff. Essential Competencies, Duties and Responsibilities Lead and conduct HEDIS compliance audit and performance measure validation activities. Apply HEDIS audit techniques and methodologi