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Behavioral Health Clinical Auditor
Elevance HealthBehavioral Health Clinical Auditor responsible for conducting quality audits and implementing improvement activities at Elevance Health. Collaborating across teams to enhance member outcomes and ensure survey readiness.
Posted 7/13/2026full-timeChicago • Colorado, Illinois, Massachusetts, Nevada • 🇺🇸 United StatesMid-LevelSenior💰 $31 - $54 per hourWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Quality Improvement, Utilization Management, and Case Management within a managed care environment, with a strong focus on data analysis and compliance with NCQA standards. Holds a relevant advanced degree and licensure in Behavioral Health, ensuring readiness for quality management activities.
Highest-signal resume keywords
Quality ImprovementUtilization ManagementCase ManagementData AnalysisNCQA Standards
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Quality Improvement ActivitiesData AnalysisReport DevelopmentFile ReviewsBehavioral Health Principles
Soft Skills
CollaborationTrend AnalysisProblem Solving
Certifications & Qualifications
Behavioral Health LicensureRNLCSWLICSWLMSWLMFTLMHC
Industry Keywords
Managed CareNCQAUtilization ReviewCase ManagementQuality Management
About the role
Key responsibilities & impact- 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
What you’ll need- 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
Comp & perks- 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