Senior HEDIS Auditor & Data Validation Lead

Health Services Advisory Group, Inc.; Oregon; Hybrid; USD 100,000 - 130,000; Full time

Job summary

Health Services Advisory Group, Inc. seeks a Senior Auditor to lead complex HEDIS compliance audits and performance measure validations for CMS and state programs in the United States.

You will evaluate data systems, measure calculations, and source data, mentoring junior staff and communicating findings to clients. Ideal candidates have strong analytical skills, experience with information systems assessments, and the ability to deliver clear, evidence-based recommendations under deadlines and

Qualifications

• The candidate will have significant experience in HEDIS compliance auditing and healthcare data validation.
• Ability to interpret complex performance measure specifications and apply them to audits.
• Experience leading audits and guiding junior staff through findings and reporting.

Responsibilities

• Lead and conduct HEDIS compliance audit and performance measure validation activities.
• Apply HEDIS audit techniques to HEDIS, CMS Core Set, state-defined, HRSA, AHRQ measures.
• Assess information systems and data sources supporting measure calculation and reporting.
• Review source code, data mapping, and measure workflows for compliance.
• Validate denominator, numerator, exclusions, eligibility, and continuous enrollment.
• Lead audit activities and interview client staff; develop evidence-based conclusions.

Skills

HEDIS auditing

Performance measurement

Data validation

Project leadership

Data analysis

Education

Bachelor's degree in healthcare or related

Tools

SQL

SAS

Python

Job description

Health Services Advisory Group, Inc. seeks a Senior Auditor to lead complex HEDIS compliance audits and performance measure validations for CMS and state programs in the United States.

You will evaluate data systems, measure calculations, and source data, mentoring junior staff and communicating findings to clients. Ideal candidates have strong analytical skills, experience with information systems assessments, and the ability to deliver clear, evidence-based recommendations under deadlines and