Senior Behavioral Health Quality Analyst — Hybrid

Elevance Health; Denver, Northern (CO, KY); Hybrid; USD 80,000 - 121,000; Full time

Benefits offered by this job

Comprehensive benefits

Equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a Senior Behavioral Health Clinical Quality Analyst to advance complex quality studies by analyzing data and regulatory criteria. The role involves on-site audits, staff training, and collaboration with providers to improve clinical quality across multiple offices in a hybrid work setting.

The position requires a BA/BS in a behavioral health field with 3+ years of related experience; an MS/MA and professional certifications are preferred.

Qualifications

• 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.

Responsibilities

• 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 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.

Skills

Data analysis

Auditing

Training

Travel

Communication

Education

BA/BS in behavioral health

MS/MA preferred

CPHQ or HCQM certification preferred

Tools

Audit tools

Job description

Elevance Health is seeking a Senior Behavioral Health Clinical Quality Analyst to advance complex quality studies by analyzing data and regulatory criteria. The role involves on-site audits, staff training, and collaboration with providers to improve clinical quality across multiple offices in a hybrid work setting.

The position requires a BA/BS in a behavioral health field with 3+ years of related experience; an MS/MA and professional certifications are preferred.