Behavioral Health Clinical Auditor
Chicago, Illinois, United States of America
Full Time
21 hours ago
$31 - $53 USD
Visa Sponsor
Key skills
Risk Management
About this role
Role Overview
- Conducts NCQA/URAC related UM and CM file reviews to ensure survey readiness
- Designs and implements quality improvement activities if goals are not met
- Analyzes data and prepares quality management reports in accordance with BH QM principles
- Participates in intra-departmental teams to improve sustainable member outcomes
- Assists in defining opportunities for improvement identified through analysis of trends
- Assists with coordinating improvement activities
Requirements
- Requires MS/MA degree in behavioral health or related field
- Minimum of 3 years experience in quality improvement and/or behavioral health, risk management and/or utilization review in a managed care setting
- Experience with NCQA standards, specifically file reviews preferred
- Strong Utilization Management and Case Management experience preferred
- Data analysis and report development strongly preferred
- Licensure in Behavioral Health (RN, LCSW,LICSW, LMSW, LMFT, LMHC) preferred
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- paid holidays
- Paid Time Off
- medical benefits
- dental benefits
- vision benefits
- short and long-term disability benefits