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Clinical Quality Audit Analyst (Candidates must reside in MA, VT, NH, CT, RI)

Location:

  • MA, Boston

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Description

Location - Remote (Candidates must reside in MA, VT, NH, CT, RI).

Responsible for developing, coordinating, implementing, and evaluating quality improvement activities including data and outcome measurements for clinical and quality programs and interventions.

Primary duties may include, but are not limited to:

  • Designs and implements quality improvement studies.

  • Analyzes data and prepares quality management reports in accordance with BH QM principles.

  • Participates in intra-departmental teams to improve sustainable member outcomes.

  • Assists in defining opportunities for improvement identified through analysis of trends.

  • Coordinates resolution of high level complaints.

  • Assists in the preparation of RFPs.

  • Assists with coordinating improvement activities that improve HEDIS and member satisfaction.

  • May meet with physician offices for provider collaboration activities and education.

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 a 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.

  • Travel may be required.

Preferred Skills, Capabilities and Experiences:

  • Previous heath care experience preferred.

  • Auditing experience preferred.


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

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