Risk Adjustment Auditor I, Remote

Centauri Health Solutions

8d • Remote

About The Position

Centauri Health Solutions provides technology and technology-enabled services to payors and providers across all healthcare programs, including Medicare, Medicaid, Commercial and Exchange. In partnership with our clients, we improve the lives and health outcomes of the members and patients we touch through compassionate outreach, sophisticated analytics, clinical data exchange capabilities, and data-driven solutions. Our solutions directly address complex problems such as uncompensated care within health systems; appropriate, risk-adjusted revenue for specialized sub-populations; and improve access to and quality of care measurement. Headquartered in Scottsdale, Ariz., Centauri Health Solutions employs 1700 dedicated associates across the country. Centauri has made the prestigious Inc. 5000 list since 2019, as well as the 2020 Deloitte Technology Fast 500™ list of the fastest-growing companies in the U.S. For more information, visit www.centaurihs.com.
Role Summary:
The Auditor uses knowledge and experience to drive process review and changes. The Auditor will conduct service line audits to review issues while ensuring compliance with service line policies, procedures, customer expectations, contract requirements and industry standards. The Auditor supports implementation of operational process or system enhancements needed to improve process efficiency or quality.

Requirements

• Bachelor’s Degree or equivalent experience
• Knowledge of industry standard quality tools
• Statistical Process Control knowledge
• Account Processing/Service line knowledge
• Strong analytical and critical thinking skills
• Strong problem-solving skills
• Excellent communication and interpersonal skills

Responsibilities

• Conducts operational and system audits
• Creates and implements QA programs to support service line needs with Leadership support.
• Good knowledge of industry standard quality tools (ex. Acceptance Sampling, Control Charting, Cp, Cpk, Six Sigma, Lean Principles, etc.)
• Good Statistical Process Control knowledge (Pareto Diagrams, cause-and-effect, process flow diagrams, histograms, tests for normality)
• Good applied business statistics (probability distributions, estimation, confidence intervals and hypothesis testing)
• Reviews internal and external records to ensure accuracy and conformance
• Identifies and analyzes process non-conformities
• Creates and implements QA programs to support service line needs
• Establishes, verifies and updates appropriate benchmarks
• Creates queries, extracts data and develops ad hoc reporting
• Uses queries and data to monitor service quality and process
• Supports business process improvement initiatives
• Performs internal consulting
• Understands and agrees to role-specific information security access and responsibilities
• Ensures safety and confidentiality of data and systems by adhering to the organizations information security policies
• Reads, understands, and agrees to security policies and complete all annual security and compliance training

Benefits

• We believe strongly in providing employees a rewarding work environment in which to grow, excel and achieve personal as well as professional goals. We offer our employees competitive compensation and a comprehensive benefits package that includes generous paid time off, a matching 401(k) program, tuition reimbursement, annual salary reviews, a comprehensive health plan, the opportunity to participate in volunteer activities on company time, and development opportunities. This position is bonus eligible in accordance with the terms of the Company’s plan. Factors which may affect starting pay within this range may include geography/market, skills, education, experience and other qualifications of the successful candidate. Centauri Health Solutions is an equal opportunity employer.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 101-250 employees