Behavioral Health Clinical Quality Audit Analyst

Full-time - Mid Level

Boston, MA

Ambulatory Health Care Services

About the position

Responsible for developing and conducting more complex behavioral health quality studies by analyzing data and patterns according to department criteria, external review organizations, and other regulatory agencies. This position will work a hybrid model (remote and office) and must live within 50 miles of our Boston, Massachusetts Pulse Point office location.

Responsibilities

• Works on more complex studies in which analysis of situations or data requires an in-depth evaluation of various factors.
• Completes weekly, monthly and quarterly progress/performance reports.
• Provides feedback to behavioral health help line leadership on performance.
• Prepares department for oversight audits.
• Prepares corrective action plans in response to oversight body's request.
• Conducts behavioral health audits of Quality Management processes and files.
• Assists with development of behavioral health help line manuals, audit tools, and guidelines.
• Participates in development and design of audit tools, policies and procedures, and behavioral health help line manuals.
• Participates in new hire orientation and on-the-job training sessions.
• Leads cross functional work group focused on quality improvement initiatives.
• Conducts AD-hoc analysis and reporting.
• Prepares mid-year and annual quality management review and program description.

Requirements

• Requires a BA/BS in a behavioral health related field.
• Minimum of 3 years behavioral health clinical and managed care or clinical quality improvement experience, or any combination of education and experience which would provide an equivalent background.

Nice-to-haves

• Proficiency in SQL is highly preferred.
• Experience in quality improvement.
• Intermediate skills in Excel.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources