• Auditing provider documentation and supporting HEDIS quality initiatives • Analyzing clinical data to identify gaps and performance opportunities • Partnering with provider offices to enhance Stars performance • Ensuring compliance with regulatory and organizational standards • Supporting provider outreach to strengthen quality measures across the network • Presenting and communicating audit results to appropriate parties • Schedule and perform routine facility, practitioner site, and medical record reviews • Identifying and evaluating areas of exposure, potential problems and liabilities • Analyze clinical data to improve individual provider compliance with education • Providing required documents and consulting support for quality and compliance audits