We appreciate your interest in Healthcare Data Management. All positions require the ability to interact well in a team environment and candidates that enjoy working in a small entrepreneurial company. Working knowledge of claims processing systems, claims adjudication, and medical and pharmacy data sets is helpful, but not required of open job positions. The following are the current job opportunities to join a growing company.

All positions are located in King of Prussia, Pennsylvania. Compensation includes salary, health insurance, 401K, and other benefits. If qualified for a position, please submit your cover letter, resume, and salary requirements to HDM.

HDM seeks an Application Developer to join our growing company who has experience building and supporting web-based applications in the Microsoft environment. The ideal candidate should have at least 5 years of experience in web development. Candidates should be self-starters capable of full-lifecycle development. This person must handle diverse responsibilities and thrive in an entrepreneurial environment.

Responsibilities:
The Application Developer is responsible for maintaining an intranet website and a desktop application that support the company's audit service. Additional duties include assisting in database functions such as import and export of raw data files to/from Microsoft SQL Server databases, building stored procedures and views, development of reports and optimizing SQL processes.

Qualifications:
At least 5 years of web development experience. Specific development skill sets include using Visual Basic, Active Server Pages, ASP.NET, HTML, DHTML, JavaScript, ADO (ActiveX Data Objects), SQL, Transact-SQL, DTS. Problem-solving and analytical abilities and a desire to offer outstanding customer service. Experience and knowledge of healthcare claim processing and administration is preferred, but not required. Bachelor's degree highly desirable.

Healthcare Data Management seeks a Health Plan Auditor with a strong background and experience in health plan administration, financial auditing, claims auditing, claims processing and payment systems, self-funded companies and third party administrators. This person is responsible for conducting audits of third party administrators on the behalf of clients that are self-insured employer groups.

Responsibilities:
HDM auditors measure administrator performance, evaluate contract compliance, evaluate discounts, audit claims and recover overpayments. The audit provides our clients with assurance of their fiduciary responsibilities, compliance with Sarbanes-Oxley, government auditing standards and measure performance of vendors. HDM auditors initiate a comprehensive onsite review at the third party administrator. The purpose is to evaluate the control environment. During the onsite visit, we assess mail operations, claim processing and check processing. We review internal control policies and procedures and determine if errors or irregularities have occurred or the likelihood of them occurring. Conduct a claim sample audit at third party administrators. The auditor determines the discount arrangement and tests it as the result of the claim audit. The auditor performs a compliance audit of the contract the client has with the administrator, including testing performance guarantees. The auditor is responsible for documenting the onsite audit and developing Draft and Final Audit Reports. The auditor participates in conference calls and meetings with clients and administrators.

Qualifications:
To qualify, you must have at least 10 years experience in health benefits auditing or health plan administration or managing claims processing, as well as strong accounting and financial experience and the ability to perform: ASO Agreement Audits, Operations/Internal Control Audits, Financial Funding Audits, Sample Claim Audits, and Discount Audits. Ability to write comprehensive audit reports, document findings, and communicate analysis in a clear style. It requires the ability to be detail oriented and focused on delivering a quality service. The person must be professional when contacting clients and administrators, have the ability to conduct entrance and exit interviews with administrators and have the ability to interface with corporate executives. Requires computer experience and the ability to use Microsoft Word and Excel. Ability to communicate by e-mail and ability to use the internet. Requires a strong personality with high-energy level and self-confidence, a self-starter, who thrives on contact with people and who enjoys operating in an entrepreneurial environment. Requires problem solving and analytical capabilities, and a desire to offer outstanding customer service. Position requires periodic travel to plan administrators for approximately one week per audit.

The Government Services (HDMGS) division of HDM seeks Medicare Part D auditors that want to be part of a new and exciting program being initiated. The audit program is focused on detecting waste, fraud, and abuse in the Part D Prescription Drug Program by the Centers for Medicare and Medicaid Services.

Responsibilities:
The selected auditor will perform desk and onsite audits of Medicare Part D plan sponsors with the objective to document compliance with regulations and contractual agreements. The audit program is focused on detecting waste, fraud and abuse with prescription drugs. The auditor is also responsible for documenting the audits and developing audit reports. Auditor participate in conference calls and meetings. The auditor will be required to travel approximately 30% of the time. A comprehensive training program will be provided.

Qualifications:
A bachelor's degree and at least 2+ years of experience. Any senior level auditors should have at least 7 years experience. Ideal candidates will have backgrounds in accounting and auditing. Experience with pharmacy programs, Medicare, and the health care industry is desirable, but not required. Must be professional and have the ability to conduct interviews and onsite audits of plans. Ability to write comprehensive audit reports, document findings, and communicate analysis in a clear style, as well as, the ability to be detail-oriented and focused on delivering a quality service. Computer experience working with Microsoft Word and Excel and the ability to communicate by e-mail and use the internet. Additionally requires a strong personality with high-energy level and self-confidence, who thrives on contact with people and who enjoys operating in an entrepreneurial environment. Requires problem-solving and analytical capabilities, and a desire to offer outstanding customer service.