Behavioral Health Quality Audit Analyst, Sr-Crisis Center of Excellence
Locations:
Atlanta, GA; Metairie, LA; Topeka, KS, or Louisville, KY. Elevance Health supports a hybrid workplace model with pulse point sites (major offices) used for collaboration, community, and connection. This position can be primarily virtual, however, will be based within 50 miles of a pulse point site listed above. We are looking for a candidate to oversee and manage the quality and assurance of our Crisis Center of Excellence team. Behavioral Health Quality Audit Analyst, Sr may include all job responsibilities identified in Job Code 550800. Responsible for participating in on-site quality external audits such as NCQA, AAS, ICH, AAHC, EQRO, and prepares audits of required documents. How you will make an impact:
Provides recommendations for quality improvement studies including selection of valid and reliable indicators and coordinates monitoring and evaluation activities upon select implementation. Analyzes data and prepares concise, accurate and meaningful quality management reports in accordance with Company procedures. Defines opportunities for improvement through trend analysis and communicates information appropriately. Assists in implementation and monitoring of quality studies including, but not limited to the development and implementation of behavioral health outcomes improvement interventions such as newsletter article, member education and outreach interventions, provider education and outreach interventions, medical record review, focus studies and surveys. Performs monthly, quarterly, annual and ad hoc medical record reviews such as HEDIS and CPG compliance. Conducts quality of care investigations and using criteria closes case appropriately or refers to BH Medical Director for further review. Prepares cases for Peer Review Committee Minimum Requirements:
Requires MS/MA degree in behavioral health or related field and a minimum of 3 years experience in quality improvement and/or behavioral health, risk management and/or utilization review in a managed care setting as well as process improvement; or any combination of education and experience which would provide an equivalent background. Specific education, type of experience and/or licensure may be required based upon contract requirements and delegated responsibilities. Preferred Requirements:
Travels to worksite and other locations as necessary. Current, valid, independent and unrestricted license such as RN, LCSW, LMFT, LMHC, LPC, or Licensed Psychologist (as allowed by applicable by state laws) is strongly preferred. #J-18808-Ljbffr Recommended Skills Auditing Behavioral Medicine Business Process Improvement Licensed Clinical Social Worker (Lcsw) Licensed Professional Counselor (Lpc) Managed Care Apply to this job. Think you're the perfect candidate? Apply on company site $('.external-apply-email-saved').on('click', function (event) window.ExternalApply = window.open('/interstitial?jobdid=j3p6f06kd61wszn43qg', 'ExternalApply-j3p6f06kd61wszn43qg'); ); $(document).ready( function() $(#ads-desktop-placeholder).html(
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n Estimated Salary: $20 to $28 per hour based on qualifications.
Atlanta, GA; Metairie, LA; Topeka, KS, or Louisville, KY. Elevance Health supports a hybrid workplace model with pulse point sites (major offices) used for collaboration, community, and connection. This position can be primarily virtual, however, will be based within 50 miles of a pulse point site listed above. We are looking for a candidate to oversee and manage the quality and assurance of our Crisis Center of Excellence team. Behavioral Health Quality Audit Analyst, Sr may include all job responsibilities identified in Job Code 550800. Responsible for participating in on-site quality external audits such as NCQA, AAS, ICH, AAHC, EQRO, and prepares audits of required documents. How you will make an impact:
Provides recommendations for quality improvement studies including selection of valid and reliable indicators and coordinates monitoring and evaluation activities upon select implementation. Analyzes data and prepares concise, accurate and meaningful quality management reports in accordance with Company procedures. Defines opportunities for improvement through trend analysis and communicates information appropriately. Assists in implementation and monitoring of quality studies including, but not limited to the development and implementation of behavioral health outcomes improvement interventions such as newsletter article, member education and outreach interventions, provider education and outreach interventions, medical record review, focus studies and surveys. Performs monthly, quarterly, annual and ad hoc medical record reviews such as HEDIS and CPG compliance. Conducts quality of care investigations and using criteria closes case appropriately or refers to BH Medical Director for further review. Prepares cases for Peer Review Committee Minimum Requirements:
Requires MS/MA degree in behavioral health or related field and a minimum of 3 years experience in quality improvement and/or behavioral health, risk management and/or utilization review in a managed care setting as well as process improvement; or any combination of education and experience which would provide an equivalent background. Specific education, type of experience and/or licensure may be required based upon contract requirements and delegated responsibilities. Preferred Requirements:
Travels to worksite and other locations as necessary. Current, valid, independent and unrestricted license such as RN, LCSW, LMFT, LMHC, LPC, or Licensed Psychologist (as allowed by applicable by state laws) is strongly preferred. #J-18808-Ljbffr Recommended Skills Auditing Behavioral Medicine Business Process Improvement Licensed Clinical Social Worker (Lcsw) Licensed Professional Counselor (Lpc) Managed Care Apply to this job. Think you're the perfect candidate? Apply on company site $('.external-apply-email-saved').on('click', function (event) window.ExternalApply = window.open('/interstitial?jobdid=j3p6f06kd61wszn43qg', 'ExternalApply-j3p6f06kd61wszn43qg'); ); $(document).ready( function() $(#ads-desktop-placeholder).html(
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n Estimated Salary: $20 to $28 per hour based on qualifications.
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