Behavioral Health Clinical Quality Analyst Senior

Elevance Health (Anthem); Denver (CO); On-site; USD 80,000 - 121,000; Full time

Benefits offered by this job

comprehensive benefits package

incentive and recognition programs

equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a Behavioral Health Clinical Quality Analyst Senior to lead complex quality studies and audits. You will analyze data, develop corrective actions, and prepare documentation for regulators.

The role emphasizes collaboration with providers and internal teams both in-office and remotely. Requires a BA/BS in a behavioral health field and 3+ years of related experience; an MS/MA and CPQH/HCQM certification are preferred.

Qualifications

• BA/BS in behavioral health field with 3+ years of behavioral health clinical and managed care or clinical quality improvement experience.
• MS/MA degree preferred.
• CPHQ or HCQM certification preferred depending on state location.

Responsibilities

• Conducts on-site behavioral health provider audits and researches quality issues.
• Performs complex studies requiring in-depth evaluation of multiple factors.
• Prepares quarterly QM coalition and oversight reports.
• Writes and updates policies, procedures, and audit tools.
• Trains new staff and coordinates audits across worksites.

Skills

Behavioral health

Auditing

Data analysis

Provider education

Education

BA/BS in behavioral health related field

MS/MA degree preferred

CPHQ/HCQM or related certification preferred

Job description

Anticipated End Date: 2026-09-27

Position Title: Behavioral Health Clinical Quality Analyst Senior

Job Description: Behavioral Health Clinical Quality Analyst Senior

Anticipated job Posting End Date: 09/27/26

Location: Denver, CO. This role requires associates to be in-office 1 - 2 days per week , fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Must be available to travel to different provider's offices as needed.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Schedule: This position will work 5 days per week on 8-hour shifts. Candidate should have availability from Monday through Friday within the operational hours of 8:00 am - 5:00 pm (MST). Additional hours, including weekends or holidays, may be required based on operational needs.

The Elevance Health Companies, Inc.

The Behavioral Health Clinical Quality Analyst Senior is responsible for developing and conducting more complex behavioral health quality studies by analyzing data and patterns according to department criteria, external review organizations, and other regulatory agencies.

How you will make an impact.

• Conducts behavioral health provider on-site audits researching behavioral health provider clinical quality issues.
• Works on more complex studies in which analysis of situations or data requires an in-depth evaluation of various factors.
• Completes quarterly progress/performance reports.
• Provides feedback to behavioral health practitioners on performance.
• Prepares department for oversight audits.
• Prepares corrective action plans in response to oversight body's request.
• Conducts behavioral health audits of QM processes and files.
• Writes policies and procedures.
• Assists with development of behavioral health provider manuals, audit tools, and guidelines.
• Coordinates collection and organization of information and documents in preparation for regulatory audits.
• Participates in development and design of audit tools, policies and procedures, and behavioral health provider manuals.
• Completes quarterly Quality Management (QM) coalition reports for submission to regulatory bodies.
• Conducts new hire orientation and on-the-job training sessions.
• Travels to worksite and other locations as necessary.

Minimum Requirements:

Requires a BA/BS in a behavioral health related field and a minimum of 3 years behavioral health clinical and managed care or clinical quality improvement experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

MS/MA degree is preferred.

Certified Professional in Healthcare Quality (CPHQ) by the National Association for Healthcare Quality, or be Certified in Healthcare Quality and Management (HCQM) by the American Board of Quality Assurance and Utilization Review Physicians or similar certifications may be required according to state location.

Previous experience conducting audits and educating providers is highly preferred.

Experience analyzing data and measuring improvements is preferred.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $80,432.00 to $120,648.00.

Location: Colorado

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution

(all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid