Quality Audit Analyst

Banner Health•Phoenix, AZ

23h•Hybrid

About The Position

The Quality Audit Analyst is part of Banner Plans & Networks’ Health Plan Quality Management Team. The role focuses on Behavioral Health chart reviews, policy and procedure evaluations, onsite agency audits, and technical assistance to help contracted providers meet regulatory and contractual standards. The position supports quality management and compliance with applicable requirements, including AHCCCS, Banner Health Plan, and the Arizona Complete Care Contract. It works in a multidisciplinary environment and involves implementing and monitoring provider programs, defining quality requirements for audit tools, and coordinating provider education on quality guidelines and performance measures. The analyst conducts risk assessments and medical record reviews, tracks and trends results, prepares audit findings reports, and reviews corrective and preventive actions. The role also assists with root cause analysis, provides technical assistance and training in continuous quality improvement methods, and closes audit findings while ensuring timely resolution of investigations and corrective actions. Audits are conducted remotely and onsite at contracted Behavioral Health agencies. Planning, documentation, and communication are hybrid/remote, but onsite audits and travel to assigned agencies are required. The schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m., with an expected 40 hours per week. Arizona residency is required, and Phoenix residence is preferred. This is an assignment-based Banner Staffing Services position; Registry/Per Diem positions do not have guaranteed hours and do not include a medical benefits package.

Requirements

Bachelor’s degree or equivalent working knowledge in a Behavioral Health-related field.
Two to four years of relevant experience in quality management, process improvement, project leadership, organization and time management, data collection and analysis, client relations, program development, process streamlining, project evaluation, budget management, or training and development.
Arizona residency required.
Self-motivation, attention to detail, strong computer skills, ability to work independently, and effective time management.
Proficiency in Microsoft Word, Excel, Outlook, and Teams, and comfort navigating various electronic health record systems.
Ability to travel to assigned agencies for onsite audits, typically up to several visits per month depending on caseload.

Nice To Haves

Arizona Board of Behavioral Health licensure and/or Certified Professional in Healthcare Quality (CPHQ).
Additional related education and/or experience.

Responsibilities

Independently conduct remote and onsite audits of contracted Behavioral Health agencies, including medical record reviews, policy and procedure assessments, risk assessments, and regulatory compliance verification.
Coordinate audit scheduling with agencies and maintain communication using virtual tools.
Provide real-time feedback, technical assistance, and training to agencies and staff to support compliance, documentation practices, and continuous quality improvement.
Compile audit reports describing findings, corrective actions, and quality improvement recommendations; track and trend medical record review results.
Navigate electronic health record systems to locate, review, and assess clinical documentation.
Implement and monitor provider programs and applicable regulatory and statutory requirements.
Define quality requirements for audit tools based on the Arizona Complete Care Contract and coordinate provider education on quality guidelines and performance measures.
Assist with root cause analysis and associated corrective and preventive actions in response to provider audits.
Review and approve appropriate corrective and preventive actions, close out audit findings, and ensure timely resolution of investigations and actions.
Suggest improvements to services, processes, or products; solve complex problems and identify solutions to non-standard requests.
Manage time and work independently to meet daily and weekly productivity metrics.