Behavioral Health Clinical Quality Audit Analyst Sr

Position Title:

Licensed Behavioral Health Quality Audit Sr.

- BCBA/ABA

Anticipated End Date:

LOCATION:

This is a field role. Maryland residency is required -- Hanover/Baltimore area. When you are not in the field, you will work virtually from your home.

HOURS:

General business hours, Monday through Friday.

TRAVEL:
Local travel is required to provider facilities.

Field:
This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

• 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.

• 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 as 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.

• You must hold a BCBA (Board Certified Behavior Analyst) for this role.
• ABA (Applied Behavior Analysis) experience preferred.
• You should be proficient in Microsoft Office applications to include Word, Excel, Outlook, Teams.

Job Level: Non-Management Exempt

Workshift: 1st Shift (United States of America)

Job Family: MED >
Clinical Quality (Non-Licensed)

For candidates working in person or virtually in the below locations, the salary
* range for this specific position is $79,716 - $119,574.

Location:

Maryland

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

• merit increases
• paid holidays
• Paid Time Off
• 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

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week.

We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.

Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal…