BH Clinical Quality Audit Analyst Sr

ATHENA Consulting is an award‑winning staffing firm serving state and local governments. Our mission is to make lives better! We make our Clients’ Lives Easier by engaging and supporting our clients and partnering with them to be the most knowledgeable staffing partner. We make our Employees’ Lives Better by identifying and cultivating their talents and matching these talents with our customers’ needs.

ATHENA places a high value on customer service, accountability and getting the job done.

This FULL‑TIME position ranges from $34.00‑$36.00 per hour depending on experience and is located in Hanover, Maryland. The BH Clinical Quality Audit Analyst Sr is responsible for participating in on‑site quality external audits such as NCQA, AAHC and EQRO, and prepares audits of required documents, and related duties as assigned.

This position is HYBRID, and will go into the office or in the community 1‑2 days a week.

• 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.
• Travels to worksite and other locations as necessary.
• Participate in developing department goals, objectives, and systems
• Participate in staff meetings and attend other meetings and seminars as assigned.
• Recommend new approaches, policies, and procedures, to continually improve efficiency of the department and services performed.
• Efficiently performs duties as assigned and works as a team within division and company.
• Perform other related duties as assigned.

• Excellent verbal, written, and listening communication skills within the English language.
• Proven, high quality customer service (internal and external customers).
• Ability to work collaboratively.
• Solid ability to analyze situations carefully and adopt appropriate courses of action.
• Ability to understand and adhere to the duties, methods, and procedures required by the position.
• Excellent organizational skills and attention to detail.
• Ability to prioritize tasks.
  
  Ability to effectively communicate to large and small group audiences.
• Proficient with Microsoft Office Suite or related software.

• Requires BS/BA 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.
• MS/MA Preferred

• Prolonged periods of sitting at a desk and working on a computer.
• Standard hours of work Monday through Friday, 8:00 am – 5:00 pm.