Senior Clinical Quality Auditor - Behavioral Health Hybrid

ATHENA Consulting; Hanover (MD); Ibrido; USD 71.000 - 75.000; Tempo pieno

Vantaggi offerti da questo lavoro

19 days PTO

12 paid holidays (13 in election years

401k with match

Medical, dental, vision insurance

Descrizione del lavoro

ATHENA Consulting, a Maryland-based staffing partner, seeks a Clinical Quality Audit Analyst Sr in Hanover for a full-time, hybrid role. You will participate in external quality audits (NCQA, AAHC, EQRO) and prepare required documentation, supporting quality improvement initiatives.

The ideal candidate has a BS/BA in behavioral health with 3+ years in quality improvement or utilization review in managed care; MS/MA is preferred. Office-based with 1–2 days per week in the community.

Competenze

• Requires BS/BA in behavioral health or related field with 3+ years in quality improvement risk management or utilization in managed care.
• MS/MA degree preferred for advanced qualifications.

Mansioni

• Participates in on-site quality external audits (NCQA, AAHC, EQRO).
• Prepares audits of required documents and associated duties.
• analyzes data and prepares quality management reports.
• Identifies opportunities for improvement through trend analysis.
• Performs medical record reviews (HEDIS/CPG) monthly, quarterly, annually.

Conoscenze

Communication skills

Customer service

Collaboration

Analytical thinking

Organizational skills

Prioritization

Public speaking

Formazione

BS/BA in behavioral health

MS/MA preferred

Strumenti

Microsoft Office Suite

Descrizione del lavoro

ATHENA Consulting, a Maryland-based staffing partner, seeks a Clinical Quality Audit Analyst Sr in Hanover for a full-time, hybrid role. You will participate in external quality audits (NCQA, AAHC, EQRO) and prepare required documentation, supporting quality improvement initiatives.

The ideal candidate has a BS/BA in behavioral health with 3+ years in quality improvement or utilization review in managed care; MS/MA is preferred. Office-based with 1–2 days per week in the community.