Full-time / Regular, Exempt - Home-Office Based
We are searching for Consultants to join our dynamic and growing team. This position will support our Medicare Part C/D Data Validation, Medicare Independent Auditor, and URAC Pharmacy service lines. The Consultant applies Attest's audit process and methodology following the specifications from governing bodies such as CMS, URAC or others. Under general supervision, Consultants research and analyze basic to complex issues surrounding the processes, operations, and systems of health care and pharmacy organizations. The position requires solid communication skills, both verbal and written, excellent time-management skills, and a strong desire to work within a team environment. No relocation required as the position is home-office based when not traveling – ability to self-motivate is a must!
Candidates across the Continental US in close proximity to a major airport are welcome to apply.
At least 2 years of working experience in healthcare operations, quality reporting, or data validation required.
Essential Duties and Responsibilities:
Core duties and responsibilities include the following. Other duties may be assigned.
· Learn Attest's approach to Medicare Part C&D Data Validation, Medicare Independent Auditor, and URAC Pharmacy audits; study provided materials and participate in facilitated and self-paced training.
· Complete planning activities, audit / validation and data driven duties associated with assigned service lines, such as:
· Adapt to Attest's necessary work ethic, key attributes and culture.
o Conduct kick-off calls with clients to ensure a collaborative and structured start to the audit process
o Participate in client onsite (or virtual) visits including interview dialogue, observation of operations and examination of documents prepared by client as well as note taking.
o Complete audit checklists and issue logs for tracking and reference purposes
o Answer client questions and draft audit findings reports
o Organize and post all client workpapers accurately and timely
o Conduct source code, census, and primary source verification (PSV) reviews
o Populate proprietary tools to evaluate client data
o Interview clients on their processes and submitted documentation for compliance with audit specifications.
· Build relationships with fellow teammates for support and troubleshooting and to establish trust and credibility.
· Complies fully with electronic workpaper standards, adheres to all company policies and procedures
· Bachelor’s Degree required OR a combination of training, education, and experience that is equivalent to one of the employment standards listed above and that provides the required knowledge and abilities
Interested candidates are invited to:
Note: Both application steps must be completed to be considered for this position.
· At least 2 years of working Healthcare Operations, Pharmacy Quality Reporting, Medicare Data Validation experience at a health plan, PBM, pharmacy organization or other health care organization is required
· Possession of a health care professional designation preferred, such as CPHQ, CHCA, CQA, CQI, Six Sigma, HIA, MMA, MHP, BPA, MPH, MBA, BSN, RN
· Strong working knowledge of Microsoft Office, especially Excel, Word, OneNote, PowerPoint. Access knowledge a plus.
· Ability to read and review health plans source code and transactions systems required.
· Strong Emotional Intelligence, Fortitude, Integrity & Ethics, Leadership and Problem Solving attributes.
· Ability to define problems, parse data, establish facts, and draw valid conclusions
· Excellent judgment and discretion; ability to handle multiple priorities simultaneously, meet deadlines, and handle work related stress
· Detail oriented while maintaining a positive attitude/ rapport
· Must be able to work independently and productively with minimum supervision
· Ability to self-motivate and thrive in a virtual and growing environment
· Team player with a 'can do' attitude that can work in a fast paced environment
· Work may require up to 50% travel during the onsite period of your main service lines, and up to 15% the remainder of the year
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Please contact us if you would like additional information or a proposal on any of the services we provide.