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Sr. Health Plan Auditor - REMOTE
Health Services Advisory Group, Inc., Des Moines
Job DetailsAre 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!SummaryHSAG is nationally recognized as an industry leader in the areas of audits, data analysis, measure development, and patient satisfaction surveys. We are in search of talented individuals who are interested in a career in healthcare performance measure auditing as an Auditor, Sr. in HSAG's Audits department within the Data Science & Advanced Analytics division. Together we can spread positive change to make healthcare better. The Auditor, Sr. position benefits from HSAG's desire to grow its staff into future leaders of healthcare quality improvement in the nation. HSAG's auditors are provided formal training in an assortment of healthcare-related topics, including health policy, clinical concepts, overview of analytic methods, data sources, and management techniques. HSAG offers:A comfortable work-life balance, and flexible work schedules.Three weeks of paid time off and 15 company-paid holidays where staff leave two hours early prior to each holiday to get a "jump start" on holiday festivities.HSAG offers a competitive benefit package which includes medical, dental, vision, tuition reimbursement and 401(k).The Auditor, Sr. is a primary contributor to the Audit 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 independently developing work plans, report templates, and timelines; independently leading contracts and project tasks; guiding coordination and Auditor I, II, and III staff in oversight and maintenance of project files and other project tasks; leading client teleconferences and meetings; performing online research on healthcare topics; leading performance measure validation audits; 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 ResponsibilitiesServe as a primary contributing member of HSAG's Audits department within DSAA.Serve as a lead auditor for all performance measure validation audits.Lead and manage multiple client contracts as primary point-of-contact and subject matter expert.Mentor and train junior staff with limited supervision.Provide oversight of supplemental Healthcare Effectiveness Data and Information Set (HEDIS®)[1] audit operations.Independently 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.Lead project management tasks, including communication (written, phone, fax).Communicate directly and manage project partners, consultants, subcontractors, and other entities on audit and performance measure validation-related projects.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.).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 independently and accurately prepare and type deliverables, reports, various project documents, letters, and other material.Lead and complete the development of written and data-oriented reports in Microsoft Word and Excel.Conduct research via the Internet including literature searches of clinical topics as assigned.Participate in and lead 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 subject matter expert to HSAG staff and clients on HEDIS 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: 101,000 to 125,000/annually DOEJob Requirements:Education and/or ExperienceMaster's degree in business, science, or healthcare-related field.At least seven years of work experience in healthcare and a minimum of ten years of work experience are required.Certified HEDIS Compliance Auditor (CHCA) required.At least five years of auditing experience and four years of experience as a lead auditor; at least four years in HEDIS auditing and/or data validation, with at least one year as a lead are required.Advanced knowledge of performance measures is required.Experience writing client reports as a lead author and report designer is required.Prior experience leading multiple medium and large projects or contracts is required.Experience writing responses to requests for proposals is required.At least two years of supervisory experience, including experience mentoring junior staff.Other QualificationsProficient 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 EnvironmentThe 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.HSAG All User Information Security ResponsibilitiesAll workforce members, volunteers, contractors or third-party agents of HSAG, Inc. who are authorized to access information systems and/or associated company data on paper or in electronic format are responsible for the following:Adhering to policies, procedures and guidelines pertaining to the protection of HSAG Company Data.Reporting actual or suspected breaches or vulnerabilities in the confidentiality, integrity or availability of HSAG Data to your immediate supervisor/manager, Corporate Compliance or Information Technology/Security Personnel.Reporting actual or suspected breaches or vulnerabilities in confidentiality, integrity or availability of Corporate Data, may be reported anonymously, via the NAVEX Global Compliance hotline at 1-800-992-9892.HSAG publishes various policies, guidelines and procedures related to the protection of Corporate Data and Information Systems. They can be found on the corporate SharePoint website. Information on requirements that may be unique to your business unit or a system you have access to can be found by talking to your supervisor/manager or designated system administrator.DisclaimerThis 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, workload, rush jobs requiring non-regular work hours, or technological developments).HSAG is an EEO Employer of Veterans protected under Section 4212.If you have special needs and require assistance completing our employment application process, please feel free to contact us. EOE M/F/Vet/DisabilityGet job alerts by email.Sign up now!
Staff Accountant
Myers and Stauffer LC, Des Moines
Exempt/Non-ExemptExemptScheduled Hours Per Week40Myers and Stauffer LC is a certified public accounting and health care reimbursement consulting firm, specializing in audit, accounting, data management and consulting services to government-sponsored health care programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45+ years of experience assisting our government clients with complex health care reimbursement and provider compliance issues, operate 20 offices and have over 900 associates nationwide.At Myers and Stauffer, you will have a career that is rewarding while also supporting our state and federal government healthcare clients that focus on those in need. We are committed to providing our employees with professional growth and development opportunities, a diverse, dynamic, challenging work environment, and a strong and visionary leadership team.What We Offer Health, Dental, and Vision insurance along with other competitive employee benefits Vacation time, sick time, paid holidays, and two floating holidays Paid Parental Leave and available support resources 401K with company matching for eligible employees Tuition reimbursement, referral bonuses, paid volunteer community service time, mentor program, and a variety of other employee programs and perks A combination of technical and leadership development training at each career milestone Up to six counseling sessions per year for eligible employees through our Employee Assistance ProgramPosition OverviewThe Staff Auditor/Accountant will perform reviews of Medicaid provider cost reports, analyze health care provider financial information, perform reimbursement calculations; and prepare written documents supporting professional decisions. Training in the government health industry is provided so employees can feel confident working on client projects within their first 30 days.Essential Functions Conduct desk reviews and various on-site audits Conduct research in order to determine billing and reimbursement compliance with relevant Medicaid or other government program regulations Conduct all phases of the audit including planning and research, risk assessment, fieldwork, reporting of findings, and other procedures as required Review applicable Federal and State policies and regulations associated with each specific audit type prior to performing the audit Prepare working papers to document scope and findings of audit in accordance with Medicaid or other government program regulations and AICPA standards Demonstrate excellence in communication skills, data gathering, analysis, reporting, and process improvement Maintain security and confidentiality of all protected health information when analyzing material Maintain thorough electronic documentation Additional responsibilities as assignedRequirements Bachelor's degree in accounting or related field required; Master's degree in accounting or related field preferred Minimum GPA of 3.25 preferred CPA or CPA candidate preferred Internship or equivalent working experience in accounting or related field preferred Experience with health care auditing and data analysis preferred Ability to review statutory/regulatory or other policy language and apply requirements Strong analytical and problem solving skills Strong verbal and written communication skills Well organized with a high degree of accuracy and attention to detail Effectively multi-task with planning and efficiency Must be able to manage multiple deadlines and prioritize assignments Proficient use of applicable technology; specifically Microsoft Office Applications (Excel, Word, etc.) Must be able to travel based on client and business needsThe TeamMyers and Stauffer takes pride in the welcoming and collaborative culture we have throughout our offices. For this position, the employee will report to one of our Managers or Senior Managers on the Cost Report/DSH engagement team.Work StyleOur general business hours are Monday through Friday 8am-5pm, but can vary based on business needs. Dependent on performance, our in-office associates are eligible for a hybrid work schedule after their initial 90-day training period. As a company, we are always willing to discuss potential flexibility that an employee may need to better suit their work-life wellbeing.Typical Interview Process Phone Screen with a Recruiter In person or remote interview with the hiring manager & team Hiring decision and job offerWe understand that changing or learning a new industry can discourage strong candidates from applying. Myers and Stauffer is committed to investing in your career development and providing the necessary resources to help you succeed. Please do not hesitate to apply, as you may be the right fit for this position or another position we have open.REASONABLE ACCOMMODATIONIf you are a qualified individual with a disability you may request reasonable accommodation if you are unable or limited in your ability to use or access this site as a result of your disability. You can request a reasonable accommodation by calling 844-558-1414 (toll free) or send an email to [email protected] .EQUAL OPPORTUNITY EMPLOYERCBIZ is an affirmative action-equal opportunity employer and reviews applications for employment without regard to the applicant's race, color, religion, national origin, ancestry, age, gender, gender identity, marital status, military status, veteran status, sexual orientation, disability, or medical condition or any other reason prohibited by law. If you would like more information about your EEO rights as an applicant under the law, please visit these following pages EEO is the Law and EEO is the Law Supplement .PAY TRANSPARENCY PROTECTION NOTIFICATIONNotice to Applicants and Associates of Affirmative Action Program