Behavioral Health Clinical Quality Analyst Senior

Socket.dev; Denver (CO); Hybrid; USD 80,000 - 121,000; Full time

Job summary

Elevance Health in Denver, CO seeks a Behavioral Health Clinical Quality Analyst Senior to develop and conduct high-level behavioral health quality studies, analyze data, and prepare audit tools. Travel to provider sites is required occasionally.

The role involves complex audits, development of corrective action plans, and collaboration with regulatory bodies. 5-day workweeks with potential for hybrid scheduling.

Qualifications

• Requires BA/BS in a behavioral health field and 3+ years of behavioral health clinical and quality improvement experience.
• MS/MA degree is preferred for advanced progression.
• CPHQ/HCQM or equivalent certification may be required per state location.

Responsibilities

• Conducts behavioral health provider on-site audits and researches clinical quality issues.
• Performs complex studies requiring in-depth data evaluation.
• Prepares corrective action plans and oversees audits for QM processes.

Skills

Audits

Data analysis

Training

Policy writing

Education

BA/BS in Behavioral Health

MS/MA preferred

CPHQ/HCQM 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-office1 - 2days 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 responsiblefor 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.

Primary duties may include, but are not limited to:

• 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). 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 and may be modified at the Company’s sole discretion, consistent with the law.

Job Level:

Non-Management Exempt

Job Family:

MED > Clinical Quality (Non-Licensed)

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.