Health Plan Auditor I- II - REMOTE - 1120/768/3980_7-3819 - Masco Corporation
Springfield, IL
About the Job
This job was posted by https://illinoisjoblink.illinois.gov : For more
information, please see:
https://illinoisjoblink.illinois.gov/jobs/12458920 Job Details
The Auditor I is a 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 supervision-healthcare auditing,
data validation, and performance measurement projects through various
stages including implementation, day-to-day operations, audit support,
evaluation, and reporting. Activities include developing work plans and
timelines; overseeing project tasks; guiding coordination staff in
oversight and maintenance of project files; leading client
teleconferences and meetings; performing online research on healthcare
topics; leading primary source verification; validating performance
results and outcomes; 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 contributing member of HSAG's Audits department within
DSAA.
- 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 supervision.
- Lead project management tasks, including communication (written,
phone, fax), under supervision.
- Communicate with project partners, consultants, subcontractors, and
other entities on audit and performance measure validation-related
projects, under 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 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 from copy, rough draft, or other
prescribed instructions.
- Support development of written and data-oriented reports in
Microsoft Word and Excel, under supervision.
- 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 reference to HSAG staff and clients on Healthcare
Effectiveness 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 National
Committee for Quality Assurance (NCQA).
Compensation: 65000 - 75000 DOE
Job Requirements:
Education and/or Experience
- Bachelor's degree in business, science, or healthcare-related
field.
- A minimum of 1 year of experience working with health care provider
data is required.
- Experience with managed care provider network adequacy monitoring
and/or reporting is preferred.
Other Qualifica ions
- 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).
HS
information, please see:
https://illinoisjoblink.illinois.gov/jobs/12458920 Job Details
The Auditor I is a 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 supervision-healthcare auditing,
data validation, and performance measurement projects through various
stages including implementation, day-to-day operations, audit support,
evaluation, and reporting. Activities include developing work plans and
timelines; overseeing project tasks; guiding coordination staff in
oversight and maintenance of project files; leading client
teleconferences and meetings; performing online research on healthcare
topics; leading primary source verification; validating performance
results and outcomes; 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 contributing member of HSAG's Audits department within
DSAA.
- 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 supervision.
- Lead project management tasks, including communication (written,
phone, fax), under supervision.
- Communicate with project partners, consultants, subcontractors, and
other entities on audit and performance measure validation-related
projects, under 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 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 from copy, rough draft, or other
prescribed instructions.
- Support development of written and data-oriented reports in
Microsoft Word and Excel, under supervision.
- 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 reference to HSAG staff and clients on Healthcare
Effectiveness 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 National
Committee for Quality Assurance (NCQA).
Compensation: 65000 - 75000 DOE
Job Requirements:
Education and/or Experience
- Bachelor's degree in business, science, or healthcare-related
field.
- A minimum of 1 year of experience working with health care provider
data is required.
- Experience with managed care provider network adequacy monitoring
and/or reporting is preferred.
Other Qualifica ions
- 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).
HS
Source : Masco Corporation