LTSS Performance & Compliance Auditor (Hybrid)

The Elevance Health Companies, Inc.; Nashville (TN); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical benefits

Dental & Vision

401(k) + match

Stock purchase plan

Life insurance

Wellness programs

Paid time off

Job summary

Elevance Health in Nashville, TN is seeking a Performance Auditor Specialist for LTSS Service Coordination & Operations. The role acts as a liaison among members, providers, care teams, and internal stakeholders to ensure timely initiation, coordination, and monitoring of services while supporting operational excellence through reporting, QA, data analysis, and process improvement.

Location: Nashville, Tennessee with a hybrid schedule (in-office 1-2 days/week).

Qualifications

• Requires a high school diploma or GED with 5+ years related experience or equivalent.
• Basic understanding of MTM processes and practices; ability to interpret operational data.

Responsibilities

• Retrieves and verifies receipt of system generated reports.
• 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

MTM processes

Analytical thinking

Data analysis

Regulatory knowledge

Reporting

Education

Bachelor's degree in Healthcare Administration, Social Work, Public Health, Business Administration, or related field

Tools

Excel

Word

Amisys

Healthcare information systems

Job description

Elevance Health in Nashville, TN is seeking a Performance Auditor Specialist for LTSS Service Coordination & Operations. The role acts as a liaison among members, providers, care teams, and internal stakeholders to ensure timely initiation, coordination, and monitoring of services while supporting operational excellence through reporting, QA, data analysis, and process improvement.

Location: Nashville, Tennessee with a hybrid schedule (in-office 1-2 days/week).