Quality Audit Analyst

bannerhealth; United States; Hybrid; USD 39,000 - 61,000; Full time

Benefits offered by this job

Weekly pay

403(b) Pre-tax retirement

Employee wellness program

Discount Entertainment tickets

Restaurant/Shopping discounts

Job summary

Banner Plans & Networks (BPN) is seeking a Quality Audit Analyst to conduct remote and onsite audits of Behavioral Health Agencies, evaluate policies and procedures, and ensure regulatory and contractual standards are met. The role offers opportunities for growth within a managed care organization and exposure to quality management and process improvement.

Responsibilities include audit planning and scheduling, providing technical assistance, and delivering detailed audit reports with findings

Responsibilities

• Independently conduct remote and onsite audits of contracted Behavioral Health Agencies, including comprehensive medical record reviews, policy and procedure assessments, and verification of regulatory compliance.
• Initiate and coordinate audit scheduling with agencies and maintain consistent communication using virtual tools.
• Provide real time feedback and technical assistance to agencies to help them meet or maintain compliance and improve documentation practices.
• Compile detailed audit reports outlining findings, corrective actions, and quality improvement recommendations.
• Navigate a variety of Electronic Health Record systems to locate, review, and assess clinical documentation.

Job description

Primary City/State: Phoenix, Arizona

Department Name:

Work Shift: Day

Job Category: Risk, Quality and Safety

Banner Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs while keeping our members in optimal health. BPN is known for its innovative, collaborative, and team-oriented approach to healthcare. We offer diverse career opportunities, from entry-level to leadership positions, and extend our innovation to employment settings by including remote and hybrid opportunities.

As a Quality Audit Analyst, you will be a vital part of the Health Plan Quality Management Team. This role focuses on Behavioral Health chart reviews, policy and procedure evaluations, onsite agency audits, and providing technical assistance to ensure our contracted providers meet regulatory and contractual standards. This role offers a strong opportunity to grow within a managed care organization and develop valuable experience in quality management and process improvement.

Key Responsibilities

• Independently conduct remote and onsite audits of contracted Behavioral Health Agencies, including comprehensive medical record reviews, policy and procedure assessments, and verification of regulatory compliance.
• Initiate and coordinate audit scheduling with agencies and maintain consistent communication using virtual tools.
• Provide real time feedback and technical assistance to agencies to help them meet or maintain compliance and improve documentation practices.
• Compile detailed audit reports outlining findings, corrective actions, and quality improvement recommendations.
• Navigate a variety of Electronic Health Record systems to locate, review, and assess clinical documentation.

Additional Details:

This is a Banner Staffing Services assignment-based position. Schedule: Monday-Friday, 8:00 a.m.-4:30 p.m. Expected Hours: 40 hours per week Benefits: This role does not include Medical or Paid Time Off (PTO) benefits. Arizona residency required. An ideal candidate will reside in Phoenix, AZ. This is a hybrid/remote position for all planning, documentation, and communication; however, onsite audits are required . Travel required to assigned agencies, typically up to several onsite visits per month depending on caseload. Candidates must be self motivated, detail oriented, and possess strong computer skills, including proficiency in Microsoft Word, Excel, Outlook, Teams, and comfort navigating various EHR systems. Success in this role requires the ability to work independently, manage time effectively, and meet daily and weekly productivity metrics.

Benefits

• Competitive wages
• Paid orientation
• Flexible Schedules (select positions)
• Fewer Shifts Cancelled
• Weekly pay
• 403(b) Pre-tax retirement
• Employee Assistance Program
• Employee wellness program
• Discount Entertainment tickets
• Restaurant/Shopping discounts
• Auto Purchase Plan

BSS Registry positions do not have guaranteed hours and no medical benefits package is offered . BSS requires Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes; employment, criminal and education).

POSITION SUMMARY

This position will be responsible for activities involving quality management and compliance with applicable regulatory requirements (AHCCCS, Banner Health Plan, Arizona Complete Care Contract ). Responsibilities will include working in a multidisciplinary environment requiring a broad range of experience, analytical, communications and interpersonal skills. Responsible for implementing and monitoring program providers, applicable regulatory and statutory requirements, and defining quality requirements for development of audit tools based on ACC Contract. Coordinate and educate quality guidelines and performance measures with providers. Assist in the root cause analysis and any associated corrective and preventive action(s) in response to provider audits. Conduct audits, including risk assessments and tracks and trend results of medical record reviews creating audit finding reports and approval of proper corrective and preventive actions, while providing technical assistance and training to providers and staff in methodologies and tools of continuous quality improvement. Close out audit findings while ensuring timely resolution of investigations and associated corrective actions.

CORE FUNCTIONS

1. Uses best practices and knowledge of internal or external business challenges to suggest improvements to services, pro