---
title: 'Senior Auditor (Healthcare) at Health Services Advisory Group, Inc.'
canonical: 'https://feeny.ai/job/senior-auditor-healthcare-health-services-advisory-group-inc-remote-t9ggpw1qgrek'
type: 'job'
last_seen: '2026-10-27'
---

# Senior Auditor (Healthcare) at Health Services Advisory Group, Inc.

- **Company:** Health Services Advisory Group, Inc.
- **Location:** Remote
- **Compensation:** $100k–$130k
- **Employment:** full-time
- **Work type:** remote
- **Posted:** 2026-10-26
- **Last confirmed live:** 2026-10-27
- **Apply:** https://jobs.lever.co/hsag/d95930e0-464c-48cd-b688-c1d2620e9c5e

## Job description

Are you passionate about improving the quality of healthcare? Are you ready to leverage your talents to make healthcare better for everyone? Do you want the opportunity to give back to your community? Do you want to have fun at work?

Then join the growing team at Health Services Advisory Group (HSAG) that is transforming the delivery of healthcare in the United States!

Summary The Senior Auditor conducts complex healthcare performance measure validation (PMV) activities. This position applies Healthcare Effectiveness Data and Information Set® (HEDIS) Compliance Audit principles, techniques, and professional judgment to the validation of HEDIS and non-HEDIS performance measures in accordance with applicable technical specifications, contractual requirements, and the Centers for Medicare/Medicaid Services (CMS) External Quality Review (EQR) Protocol 2. The Senior Auditor evaluates information systems, data integrity, measure calculation processes, source code and programming logic, medical record review processes, and reported performance measure results to determine whether measures are accurate, reliable, and calculated in accordance with established specifications. The Senior Auditor will have the ability to work independently while providing technical leadership and mentoring to other staff. Essential Competencies, Duties and Responsibilities Lead and conduct HEDIS compliance audit and performance measure validation activities. Apply HEDIS audit techniques and methodologies to HEDIS, CMS Core Set, state-defined, HRSA, AHRQ, and other performance measures, as applicable. Conduct information systems assessments and evaluate systems and processes supporting performance measure calculation and reporting. Assess the accuracy, completeness, and integration of enrollment, claims/encounter, provider, pharmacy, laboratory, medical record, supplemental, vendor, and other applicable data sources. Review source code, programming logic, data mapping, measure workflows, and calculation methodologies for compliance with measure specifications. Validate denominator, numerator, exclusions, eligibility, continuous enrollment, clinical coding, sampling, and other measure-specific requirements. Conduct primary source verification and record-level testing to verify the accuracy of source data and reported results. Evaluate medical record review processes, abstraction methodologies, sampling, and quality-control procedures, as applicable. Lead virtual and onsite audit activities and conduct interviews with client staff responsible for information systems, data management, programming, quality measurement, and reporting. Identify audit findings, assess their impact on measure validity, and develop clear, evidence-based conclusions and recommendations. Prepare and review audit workpapers, validation tools, findings, and client-facing reports. Provide senior-level review and technical guidance to auditors and other project staff. Communicate complex technical findings effectively to clients, state Medicaid agencies, internal leadership, and other stakeholders. Support development and continuous improvement of audit methodologies, tools, workpapers, and reporting processes. Maintain current knowledge of HEDIS requirements, CMS EQR protocols, CMS Core Set specifications, and other applicable performance measurement standards.

## Minimum Qualifications

Bachelor's degree in healthcare administration, public health, health information management, nursing, information systems, statistics, data analytics, or a related field. Significant experience in HEDIS compliance auditing, healthcare performance measurement, performance measure validation, healthcare data validation, or a related field. Demonstrated ability to interpret and apply complex performance measure specifications. Experience evaluating healthcare information systems, data flows, and data used for performance measure reporting. Experience reviewing source code, programming logic, or measure calculation methodologies, directly or in collaboration with technical staff. Experience conducting audits, developing findings, documenting supporting evidence, and communicating results to clients and stakeholders. Demonstrated ability to lead complex audit activities and provide technical guidance to other staff.

## Preferred Qualifications

Experience conducting NCQA HEDIS Compliance Audits. Experience conducting performance measure validation under CMS EQR Protocol 2. Experience with Medicaid and/or CHIP managed care programs. Experience validating CMS Core Set, state-defined, or other non-HEDIS performance measures. Experience with information systems assessments, primary source verification, medical record review validation, and source code review. Familiarity with SQL, SAS, Python, or similar data-query or programming tools. Knowledge, Skills, and Abilities Advanced knowledge of HEDIS performance measurement and audit concepts. Knowledge of CMS EQR performance measure validation requirements and methodologies. Ability to apply established HEDIS audit techniques to HEDIS and non-HEDIS performance measures. Strong understanding of healthcare information systems, data flows, and performance measure calculation processes. Strong analytical, investigative, and problem-solving skills. Ability to interpret technical specifications and translate them into effective audit procedures. Sound professional judgment in evaluating audit evidence and determining the significance of findings. Strong written, verbal, and interpersonal communication skills. Ability to prepare clear, concise, and defensible technical documentation. Ability to manage multiple priorities and meet contractual and regulatory deadlines. Ability to work independently while providing technical leadership and mentoring to other staff.

Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, work load, rush jobs requiring non-regular work hours, or technological developments).

HSAG is an EEO Employer of Veterans protected under Section 4212. If you have special needs and require assistance completing our employment application process, please feel free to contact us.

EOE M/F/Veteran/Disability

## About Health Services Advisory Group, Inc.

## Company Overview
- **One-liner**: Health Services Advisory Group, Inc. (HSAG) is a privately held healthcare quality improvement organization that provides external quality review, data analytics, and survey services to Medicare, Medicaid, and other health programs.
- **Entity Type**: Private (no disclosed funding rounds; appears bootstrapped or organically funded)
- **Headquarters**: Phoenix, Arizona, United States
- **Founded**: 1979
- **Founders**: A group of medical professionals (exact names not publicly listed)

## Core Business
- **Primary industry**: Healthcare quality improvement / Healthcare advisory services
- **Target customers**: Government agencies (Centers for Medicare & Medicaid Services), state Medicaid programs, hospitals, nursing homes, physician practices, managed care organizations — primarily B2G and B2B within the healthcare ecosystem.
- **Mission statement**: “To be a positive force in health care by providing helpful information and quality expertise to those who deliver and those who receive health services.”

## Products & Services
- **QIN-QIO Services (Quality Innovation Network – Quality Improvement Organization)**: HSAG works under federal contracts to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries in Arizona and California.
- **EQRO Services (External Quality Review Organization)**: Conducts health plan-specific reviews of quality of care, timeliness, and access for Medicaid managed care, behavioral health, and prepaid inpatient health plans across multiple states.
- **Data Science & Advanced Analytics**: Provides outcomes measurement, satisfaction surveys, and quality improvement interventions through the Survey, Research & Analysis Division.
- **Audit & Validation Services**: Offers audit services for managed care organizations, including MIPS attestation assistance and compliance reviews.
- **Healthcare Policy & Quality Measurement (HPQM)**: Provides clinical and analytical expertise for quality measure development and healthcare policy evaluation.

## Market Standing
- **Valuation**: Not disclosed (private company)
- **Key Metric**: Annual Revenue — approximately $45 million (source: ZoomInfo, likely 2024-2025 estimate). Total headcount reported as 305 (ZoomInfo, -1.6% YoY) or 511 (Built In, possibly broader definition). Conflicting headcount data exists; the lower figure likely reflects core employees, while the higher may include contractors or broader workforce.
- **Notable Clients/Contracts**: CMS (Centers for Medicare & Medicaid Services) as a QIN-QIO for Arizona and California; EQRO contracts for 15+ states including Arizona, California, Colorado, and others.
- **Growth Signals**: In May 2025, HSAG was awarded the CMS QIN-QIO 13th Statement of Work (13SOW) regional contract, extending its federal work. The company’s LinkedIn following grew 56.2% year-over-year, indicating increased brand visibility.

## Competitive Advantages
- **Deep government expertise**: 40+ years of experience working directly with CMS and state Medicaid agencies, creating high barriers to entry for competitors.
- **Dual role as QIN-QIO and EQRO**: Few organizations hold both designations, giving HSAG a unique vantage point across Medicare and Medicaid quality improvement.
- **Established trust and track record**: Helped Laguna Honda Hospital & Rehabilitation Center (the second largest nursing home in the U.S.) regain nursing home certification after two years of guidance.
- **Multi-state footprint**: Provides services in 16 states, with physical offices in Arizona, Hawaii, Florida, and California.

## Strategic Focus
- **Expanding federal and state contracts**: Recent award of the QIN-QIO 13SOW contract signals continued investment in Medicare quality improvement.
- **Broadening service offerings**: Introduction of MIPS Attestation Assistance Services (January 2025) and expansion of audit capabilities for managed care organizations.
- **Data-driven quality improvement**: Emphasis on advanced analytics and informatics to support federal and state program goals.

## Why Work Here
- **Work environment**: Hybrid and remote options available; job postings list “Remote” or “Hybrid” for many roles (e.g., Accounting Manager – Hybrid; Healthcare Auditor II – Remote).
- **Culture**: Employee rating of 3.4/5 on Indeed (208 reviews), with work-life balance rated 3.7 and compensation 3.7. Career development rated 3.4. Reviewers note exposure to a wide variety of Medicare and Medicaid contracts and good training in informatics and analytics.
- **Benefits**: Dental insurance, 401(k), pension plan, and family/childcare benefits reported (Built In). Salaries for recent postings: Healthcare Auditor II $80k–$90k/year; Health Plan Auditor I $62k–$70k/year.
- **Offices**: 4+ offices including Phoenix (HQ), Glendale (AZ), Tempe (AZ), Tampa (FL), and Kalaeloa (HI).
- **Mission-driven work**: Opportunity to directly impact healthcare quality for Medicare and Medicaid beneficiaries across the country.

## Sources
1. [ZoomInfo - Health Services Advisory Group](https://www.zoominfo.com/c/health-services-advisory-group-inc/363315142)
2. [Built In - Health Services Advisory Group Careers](https://builtin.com/company/health-services-advisory-group)
3. [LinkedIn - Health Services Advisory Group](https://linkedin.com/company/health-services-advisory-group)
4. [Indeed - Health Services Advisory Group Reviews](https://www.indeed.com/cmp/Health-Services-Advisory-Group,-Inc.)
5. [The Org - Health Services Advisory Group](https://theorg.com/org/health-services-advisory-group)
6. [HSAG Careers Page (Lever)](https://jobs.lever.co/hsag)

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