Experienced HEDIS Quality Auditor for Healthcare Quality Improvement Initiatives - Remote Contract Opportunity

Transforming Healthcare Quality with Walker Healthforce

Walker Healthforce is a renowned healthcare consulting firm that has been at the forefront of delivering exceptional healthcare IT and clinical solutions to hospitals, health systems, and payer organizations across the nation for nearly two decades. As a certified WMBE, we pride ourselves on our expertise, precision, and integrity. We are now seeking an experienced HEDIS Quality Auditor to join our team on a contract basis, supporting one of our esteemed healthcare clients based in New Jersey.

About the Role

This is a unique opportunity for a seasoned healthcare professional to leverage their expertise in HEDIS quality auditing to drive quality improvement initiatives. As a HEDIS Quality Auditor with 3-5 years of experience, you will play a pivotal role in ensuring compliance with documentation standards, assessing the quality of medical records, and providing education to healthcare providers. This is a remote contract position with a duration of 6 months, starting on August 1, 2025.

Key Responsibilities

• Conduct on-site reviews at participating provider offices to assess the environment, quality of physician’s medical records, and compliance with documentation standards.
• Prepare comprehensive documentation to summarize on-site findings, providing education and discussing opportunities for improvement with physicians.
• Provide data support services to facilitate the quality improvement process and analyze trends/patterns for health management.
• Assist the Quality Management department with various special projects and focused clinical studies.
• Perform related tasks or special studies as requested, demonstrating flexibility and a willingness to adapt to changing priorities.
• Assist in training internal staff, providers, and vendors on programs and audit standards, both on-site and remotely.
• Serve as the in-house representative and project lead for state audits, ensuring seamless coordination and communication.
• Analyze audit findings, produce various reports as requested, and coordinate the Corrective Action Plan (CAP) process for assigned audit types.
• Conduct re-audits to ensure prior deficiencies were addressed, demonstrating a commitment to continuous quality improvement.

Essential Qualifications

To be considered for this role, you must possess:

• Three to five years of related business experience, preferably in the healthcare industry, with a proven track record of success.
• A Practical Nurse License or an active New Jersey Registered Nurse License, demonstrating your expertise in healthcare.
• A valid Motor Vehicle driver's license and access to an automobile, as on-site reviews may be required.
• Knowledge of managed care principles, medical terminology, and PC software, with excellent verbal and written communication skills.
• Excellent organizational skills, with the ability to prioritize tasks and manage multiple projects simultaneously.
• Strong analytical skills, with good problem-solving and conflict resolution abilities.
• Good decision-making skills, with the ability to make informed decisions in a fast-paced environment.
• Strong PC skills, with proficiency in related software applications.
• Strong presentation skills, with the ability to effectively communicate with various stakeholders.

Preferred Qualifications

While not mandatory, the following qualifications are highly desirable:

• Knowledge of URAC accreditation standards and HEDIS principles, demonstrating your expertise in healthcare quality auditing.
• Knowledge of health management or patient education, showcasing your ability to drive quality improvement initiatives.

What We Offer

At Walker Healthforce, we offer a comprehensive benefits package, including:

• A competitive compensation package, with weekly pay via Direct Deposit.
• Medical, Dental, and Vision benefits, ensuring your overall well-being.
• 401(k) options, helping you plan for your future.
• Access to our top-ranked team of recruiting and placement specialists, providing continuous support throughout your contract.
• Professional resume development and interview preparation, empowering you to take your career to the next level.

Why Work with Walker Healthforce?

By joining our team, you will become part of a dynamic and culturally diverse workforce, committed to delivering exceptional results in the healthcare consulting community. As an Equal Opportunity Employer, we foster an inclusive environment that values diversity and promotes equal opportunities for all. Our team is dedicated to:

• Providing end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations nationwide.
• Exceeding expectations through our expertise, precision, and integrity.
• Empowering our professionals to grow and develop their skills through continuous training and support.

Career Growth Opportunities

As a HEDIS Quality Auditor with Walker Healthforce, you will have the opportunity to:

• Develop your skills in healthcare quality auditing, with a focus on HEDIS principles and URAC accreditation standards.
• Enhance your knowledge of health management and patient education, driving quality improvement initiatives.
• Collaborate with our team of experts to deliver exceptional results, fostering a culture of continuous learning and growth.

Work Environment and Company Culture

At Walker Healthforce, we pride ourselves on our inclusive and dynamic work environment. As a remote contract professional, you will have the flexibility to work from anywhere, while still being part of a collaborative and supportive team. Our company culture is built on:

• A commitment to diversity, equity, and inclusion, promoting equal opportunities for all.
• A passion for delivering exceptional results, driving quality improvement initiatives in the healthcare industry.
• A culture of continuous learning and growth, empowering our professionals to develop their skills and expertise.

Join Our Team

If you are a motivated and experienced healthcare professional looking for a challenging and rewarding contract opportunity, we encourage you to apply for this HEDIS Quality Auditor role. With Walker Healthforce, you will become part of a team that is dedicated to transforming healthcare quality through expertise, precision, and integrity. Apply today and take the first step towards a fulfilling career with our esteemed organization!