Senior Auditor - HEDIS & Healthcare Performance Lead

Health Services Advisory Group; United States; Hybrid; USD 85,000 - 110,000; Full time

Job summary

Health Services Advisory Group (HSAG) is seeking an experienced audit professional to lead complex healthcare performance measure validation and HEDIS compliance audits. The role involves applying HEDIS standards, CMS EQR protocols, and professional judgment to validate performance measures, while working independently and mentoring other staff.

The candidate will assess information systems, data integrity, programming logic, and measure calculation processes; conduct virtual and onsite audits

Qualifications

• Significant experience in HEDIS compliance auditing.
• Experience in healthcare performance measurement and data validation.
• Strong analytical, communication, and problem-solving skills.
• Ability to interpret complex technical specifications and lead audit projects.

Responsibilities

• Lead complex healthcare performance measure validation and HEDIS compliance audit activities.
• Assess information systems, data integrity, programming logic, and measure calculation processes.
• Conduct virtual and onsite audits, including interviews with client staff and primary source verification.
• Develop audit findings, evidence-based conclusions, and client-facing reports.

Skills

HEDIS auditing

Healthcare performance measurement

Data validation

Analytical skills

Job description

Health Services Advisory Group (HSAG) is seeking an experienced audit professional to lead complex healthcare performance measure validation and HEDIS compliance audits. The role involves applying HEDIS standards, CMS EQR protocols, and professional judgment to validate performance measures, while working independently and mentoring other staff.

The candidate will assess information systems, data integrity, programming logic, and measure calculation processes; conduct virtual and onsite audits