Remote HEDIS Quality Audit Lead

HCSC Group; United States; Remote; USD 42,000 - 76,000; Full time

Benefits offered by this job

Health benefits

401(k)

Pension

Paid time off

Paid parental leave

Disability insurance

Life insurance

Employee assistance program

Paid holidays

Tuition reimbursement

Incentives

Job summary

Health Care Service Corporation in the United States seeks a licensed RN/LPN QA auditor to evaluate HEDIS review requirements, perform data validation and quality audits prior to production release. The role emphasizes accuracy, adherence to HEDIS guidelines and independent work in a remote environment.

The candidate should hold an active RN or LPN license with strong clinical knowledge, experience reviewing medical records for quality, and the ability to manage multiple priorities while

Qualifications

• Bachelor’s degree with 2 years of testing experience OR 4 years of testing experience.
• Clear verbal, written and interpersonal skills for team work.
• Analytical problem solving with initiative and accountability.
• Knowledge of testing methodologies and the SDLC.
• Experience with automated testing tools.

Responsibilities

• Evaluate requirements for HEDIS medical record review, data validation and quality auditing.
• Develop and execute audit strategies and review medical records for quality and compliance.
• Research, investigate and resolve data issues; provide accurate audit status updates.

Skills

RN/LPN license

Testing experience

SDLC knowledge

Automated testing tools

Analytical skills

Teamwork

Clear communication

Education

Bachelor's degree in technology or business administration

Tools

Arcadia

Job description

Health Care Service Corporation in the United States seeks a licensed RN/LPN QA auditor to evaluate HEDIS review requirements, perform data validation and quality audits prior to production release. The role emphasizes accuracy, adherence to HEDIS guidelines and independent work in a remote environment.

The candidate should hold an active RN or LPN license with strong clinical knowledge, experience reviewing medical records for quality, and the ability to manage multiple priorities while