HEDIS Quality Auditor | Remote | Newark, NJ | Contract
HEDIS Quality Auditor | 3-5 years | Remote | Newark, NJ | Contract Walker Healthforce is seeking a HEDIS Quality Auditor with 3-5 years to support a healthcare client based out of New Jersey. This is a 6-month contract opportunity. START DATE: 8/1/2025 WORKER TYPE: W2 CORE REQUIREMENTS:
- Three to five years’ related business experience, preferably in the health care industry
- Practical Nurse License or an active New Jersey Registered Nurse License
- Valid Motor Vehicle driver's license and access to an automobile
- Knowledge of managed care principles
- Knowledge of medical terminology
- Knowledge of PC's and related software
- Excellent verbal and written communication skills
- Excellent organizational skills
- Strong analytical skills
- Good problem solving/conflict resolution skills
- Good decision-making skills
- Strong PC skills
- Strong presentation skills
ADDITIONAL REQUIREMENTS:
- Must be local to New Jersey, New York, Pennsylvania, Delaware, or Connecticut
WE CONSIDER IT A BONUS IF YOU ALSO HAVE:
- Knowledge of URAC accreditation standards and HEDIS principles.
- Knowledge of health management or patient education.
JOB RESPONSIBILITIES:
- Conduct on-site reviews at participating provider offices to assess environment, quality of physician’s medical records, and compliance with documentation standards
- Prepare appropriate documentation to summarize on-site findings with physicians, providing education and discussing opportunities for improvement
- Provide data support services to facilitate the process and analyze trends/patterns for quality improvement and health management
- Assist the Quality Management department with various special projects and focused clinical studies.
- Perform related tasks or special studies as requested
- Assist in training internal Horizon NJ Health staff, providers and vendors on programs and audit standards, both on and off site
- In-house representative and project lead for state audits
- Responsible for analysis of audit findings
- Produce various reports as requested
- Coordinate and manage the Corrective Action Plan (CAP) process for assigned audit type
- Conduct reaudit ensuring prior deficiencies were addressed
WHAT WE OFFER:
- Competitive compensation package
- Weekly pay via Direct Deposit
- Medical, Dental & Vision available
- 401k options
WHY WORK WITH WALKER?
- Access to our top ranked team of recruiting and placement specialists
- Continuous, one-on-one support from a dedicated engagement manager
- Professional resume development and interview preparation
Contact our Recruiting Team today to experience the Walker Healthforce difference! ABOUT US: Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today! We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. #IND1 Apply to this Apply Job! Apply to this Job