Hybrid LTSS Performance & Process Auditor

Elevance Health, Inc.; Nashville (TN); Hybrid; USD 70,000 - 100,000; Full time

Job summary

Elevance Health, Inc. in Nashville, TN seeks a Performance Auditor Specialist for LTSS Service Coordination & Operations. The role blends service coordination with operational support to monitor services, ensure timely initiation, and drive quality improvements through data reporting and analysis.

Hybrid work includes in-office 1–2 days weekly; remote work may be considered within policy. The position focuses on governance, operational dashboards, and provider collaboration to enhance member

Qualifications

• Requires a high school diploma or GED; 5+ years related experience.
• Basic understanding of MTM processes and practices.
• Bachelor's or higher degree preferred in Healthcare Admin, Social Work, Public Health, or related field; equivalent background considered.

Responsibilities

• Retrieves and verifies receipt of system generated reports, following up when reports are not received.
• Enters claims timeliness statistics for each line of business processed on Amisys.
• Creates, updates and prepares workpapers for each sample.
• Prepares all claims sample listings.
• Creates, updates, and maintains spreadsheets documenting weekly inquiry population and sample size data.
• Compiles the call detail from individual workpapers for telephone tape samples.
• Performs basic audits and assists with audits as a backup.

Skills

LTSS knowledge

Data analytics

Auditing

Quality improvement

Problem-solving

Communication

Education

Bachelor's degree in Healthcare Administration/related field

Tools

Amisys

Microsoft Excel

Microsoft Word

Healthcare reporting tools

Job description

Elevance Health, Inc. in Nashville, TN seeks a Performance Auditor Specialist for LTSS Service Coordination & Operations. The role blends service coordination with operational support to monitor services, ensure timely initiation, and drive quality improvements through data reporting and analysis.

Hybrid work includes in-office 1–2 days weekly; remote work may be considered within policy. The position focuses on governance, operational dashboards, and provider collaboration to enhance member