HEDIS Certified Audit Director

Job Summary

Leading the Medicaid Services division, the full-time salaried HEDIS Certified Audit Director will oversee healthcare audit projects, manage teams, and ensure high-quality deliverables while working remotely.

Key responsibilities

• Provide operational oversight of Performance Measure Validation (PMV) and HEDIS audit activities
• Direct project planning, implementation, and performance monitoring across various audit projects
• Supervise and mentor junior staff while ensuring accurate and timely customer deliverables

Required qualifications

• Bachelor's degree or equivalent experience in Medicaid managed care, HEDIS, performance measures, or audits
• Credentialed as an NCQA Certified HEDIS Compliance Auditor (CHCA) or proficiency in HEDIS reporting
• At least fifteen (15) years of work experience, with a minimum of ten (10) years in healthcare, preferably Medicaid
• Experience in budget and cost proposal development, including leading cost proposal efforts
• Proven expertise in Medicaid, health plan operations, or managed care