[Remote] Behavioral Health Clinical reputed company Audit Analyst Senior - Maryland

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a health company dedicated to improving lives and communities. The Behavioral Health Clinical reputed company Audit Analyst Senior will be responsible for participating in reputed company audits and preparing necessary documents, while also analyzing data and providing recommendations for reputed company improvement.

Responsibilities

• Participates in on-site reputed company reputed company audits such as reputed company, AAHC and EQRO, and prepares audits of required documents
• Provides recommendations for reputed company improvement studies including selection of reputed company and reliable indicators and coordinates monitoring and evaluation activities upon select implementation
• 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 reputed company, 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
• Conducts reputed company of care investigations and using reputed company closes case appropriately or refers to BH Medical Director for reputed company review
• Prepares cases for Peer Review Committee
• Travels to worksite and other locations as necessary

Skills

• 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
• Specific education, type of experience and/or licensure may be required based upon contract requirements and delegated responsibilities
• Knowledge of C.O.M.A.R highly preferred
• Previous experience working reputed company Maryland reputed company is highly preferred
• Previous experience working in reputed company Health is preferred

Benefits

• Comprehensive benefits package (subject to eligibility requirements)
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (reputed company benefits are subject to eligibility requirements)
• reputed company increases
• reputed company holidays
• reputed company Time Off
• 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
• Virtual role enables associates to work reputed company full-time, except for required in-person training sessions
• Workshift: 1st Shift (reputed company of America)
• Work Hours: Monday through Friday, reputed company to 5PM EST.

reputed company