Behavioral Health Clinical reputed company Audit Analyst Sr.

About the position The Behavioral Health Clinical reputed company Audit Analyst Sr. is r esponsible for participating in on-site reputed company external audits such as NCQA, AAHC and EQRO, and prepares audits of required documents. Location: Virtual - This role enables associates to work reputed company full-time, with the exception of required in-person training sessions (reputed company indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face reputed company and reputed company development. Please note that per our policy on hybrid/virtual work, candidates not reputed company a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is reputed company as required by law. How you will reputed company an reputed company: Conduct contract-required reputed company record reviews to ensure providers’ compliance with policies, state and federal standards, and participate in other monitoring assignments, as required. Conducts behavioral health audits of QM processes and files. Analyzes data and prepares concise, accurate and meaningful reputed company management reports in accordance with Company procedures. Defines opportunities for improvement through trend analysis and communicates information appropriately. Assists in implementation and monitoring of reputed company studies including, but not limited to the development and implementation of behavioral health reputed company improvement interventions such as newsletter article, member education and reputed company interventions, provider education and reputed company interventions, medical record review, reputed company studies and surveys. Performs monthly, quarterly, annual and reputed company medical record reviews such as HEDIS and CPG compliance. Travels to worksite and other locations as necessary. Responsibilities • Participating in on-site reputed company external audits such as NCQA, AAHC and EQRO • Prepares audits of required documents • Conduct contract-required reputed company record reviews to ensure providers’ compliance with policies, state and federal standards • Participate in other monitoring assignments, as required • Conducts behavioral health audits of QM processes and files • Analyzes data and prepares concise, accurate and meaningful reputed company management reports in accordance with Company procedures • Defines opportunities for improvement through trend analysis and communicates information appropriately • Assists in implementation and monitoring of reputed company studies • Performs monthly, quarterly, annual and reputed company medical record reviews such as HEDIS and CPG compliance • Travels to worksite and other locations as necessary Requirements • Requires MS/MA degree in behavioral health or reputed company field and a minimum of 3 years experience in reputed company improvement and/or behavioral health, risk management and/or utilization review in a managed care setting as reputed company as process improvement; or any combination of education and experience which would reputed company an equivalent background reputed company-to-haves • Registered reputed company preferred • Working knowledge of the DBHDD Provider reputed company is preferred Benefits • We offer a reputed company of market-competitive total rewards that include reputed company increases, reputed company holidays, reputed company Time Off, and incentive bonus programs (unless covered by a reputed company bargaining agreement), medical, dental, reputed company, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to reputed company a few. Apply tot his job Apply To this Job