Performance Auditor Specialist

• Retrieves and verifies receipt of system generated reports, following up when reports are not received.
  
• Enters claims timeliness statistics for each line of business processed on Amisys.
  
• Creates, updates and prepares workpapers for each sample.
  
• Prepares all claims sample listings.
  
• Creates, updates, and maintains spreadsheets documenting weekly inquiry population and sample size data.
  
• Compiles the call detail from individual workpapers for telephone tape samples.
  
• Performs basic audits and assists with audits as a backup.
  

• Experience supporting LTSS, CHOICES, ECF CHOICES, IDD, Medicaid waiver programs, or other long-term services and supports preferred.
  
• Knowledge of Person-Centered Planning and interdisciplinary care coordination preferred.
  
• Experience with provider collaboration, referral coordination, and service initiation processes preferred.
  
• Experience performing operational audits, quality reviews, or claims-related reporting preferred.
  
• Experience developing operational dashboards, data analytics, and performance reporting preferred.
  
• Experience leading projects, mentoring staff, or facilitating cross-functional initiatives preferred.
  
• Bachelor's degree in Healthcare Administration, Social Work, Human Services, Public Health, Business Administration, or a related field preferred.
  
• Strong analytical, problem-solving, and organizational skills with the ability to interpret operational data, identify process improvement opportunities, manage multiple priorities, and meet deadlines preferred.
  
• Excellent verbal, written, and interpersonal communication skills, with the ability to build collaborative relationships across members, providers, multidisciplinary teams, and internal stakeholders preferred.
  
• Proficiency with Microsoft Office applications, including Excel and Word, as well as healthcare information systems and reporting tools preferred.
  

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and 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, to name a few.

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. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. 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 Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact View email address on aplitrak.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act