Description

Qualified applicants will live in the Atlanta, GA area

General Summary

We are currently seeking a BH Clinical Quality Audit Analyst Senior (Quality Assessor) to join our team in Georgia within the Quality Management (QM) Department. The Quality Assessor will be responsible for conducting quality reviews both on-site at provider locations and remotely. Candidates must be able to travel extensively within the state of Georgia.

Duties and Responsibilities

• Conduct contract-required quality record reviews to ensure providers’ compliance with policies, state and federal standards, participate in other monitoring assignments, as required.
• Travel within the Georgia is required for this position. When not traveling to provider locations, this position is remote-based.
• Prepares written reports on quality improvement activities that describe results, strengths, opportunities for improvement and recommendations.
• Identify trends and patterns of deficiencies within the medical record; evaluate results, identify and communicate areas for improvement within the system.
• Conduct individual and staff interviews, compile and report results.
• Prepares and presents trainings to providers, as needed.

Minimum Entry Level Qualifications

Education: Master's degree in health related field or 5 years of experience in a behavioral health related field.

Licensure: Preferred licensure in a mental health related field (Ph.D., RN, LCSW, LPC, LMFT, LMSW, etc.). must be current and unrestricted

Years and Type of Relevant Work Experience:

• Minimum three (3) years’ work experience in Quality Management or healthcare field. Knowledge of quality improvement philosophy and techniques and state, federal guidelines and regulations preferred.
• Relevant Work Experience: Experience in behavioral health. Requires experience with treatment record documentation or some clinical or quality-related knowledge of treatment record documentation requirements, ability to understand contract and other regulatory requirements. Knowledge of the Georgia DBHDD Provider Manual preferred. Experience conducting audits, training and basic knowledge of procedure codes, strongly preferred.
• This position requires highly-developed organizational and verbal/written communication skills. The individual for this position must be able to manage multiple priorities and work effectively in a fast-paced environment.
  

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. A Fortune 20 company with a longstanding history in the healthcare industry, 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 in certain patient/member-facing roles 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 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. 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.