Senior Behavioral Health Quality & Compliance Analyst

Elevance Health (Anthem); Denver (CO); On-site; USD 80,000 - 121,000; Full time

Benefits offered by this job

comprehensive benefits package

incentive and recognition programs

equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a Behavioral Health Clinical Quality Analyst Senior to lead complex quality studies and audits. You will analyze data, develop corrective actions, and prepare documentation for regulators.

The role emphasizes collaboration with providers and internal teams both in-office and remotely. Requires a BA/BS in a behavioral health field and 3+ years of related experience; an MS/MA and CPQH/HCQM certification are preferred.

Qualifications

• BA/BS in behavioral health field with 3+ years of behavioral health clinical and managed care or clinical quality improvement experience.
• MS/MA degree preferred.
• CPHQ or HCQM certification preferred depending on state location.

Responsibilities

• Conducts on-site behavioral health provider audits and researches quality issues.
• Performs complex studies requiring in-depth evaluation of multiple factors.
• Prepares quarterly QM coalition and oversight reports.
• Writes and updates policies, procedures, and audit tools.
• Trains new staff and coordinates audits across worksites.

Skills

Behavioral health

Auditing

Data analysis

Provider education

Education

BA/BS in behavioral health related field

MS/MA degree preferred

CPHQ/HCQM or related certification preferred

Job description

Elevance Health is seeking a Behavioral Health Clinical Quality Analyst Senior to lead complex quality studies and audits. You will analyze data, develop corrective actions, and prepare documentation for regulators.

The role emphasizes collaboration with providers and internal teams both in-office and remotely. Requires a BA/BS in a behavioral health field and 3+ years of related experience; an MS/MA and CPQH/HCQM certification are preferred.