Health Underwriter, Sr. jobs in Kentucky

Health Underwriter, Sr. reviews applications for coverage, gathers data and assesses risk related to qualifying a candidate for health insurance. Calculates and recommends pricing. Being a Health Underwriter, Sr. performs group and/or individual underwriting. Requires a bachelor's degree. Additionally, Health Underwriter, Sr. typically reports to supervisor or manager. The Health Underwriter, Sr. contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Health Underwriter, Sr. typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)

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Behavioral Health Clinical Quality Audit Analyst, Sr.
  • Elevance Health
  • KY, KY FULL_TIME
  • Description

    Job Description

    A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. 

    BH Clinical Quality Audit Analyst, Sr

    Responsible for participating in on-site quality external audits such as NCQA, AAHC and EQRO, and prepares audits of required documents.


    Primary duties to include:

    • Provides recommendations for quality improvement studies including selection of valid and reliable indicators and coordinates monitoring and evaluation activities upon select implementation.
    • Analyzes data and prepares concise, accurate and meaningful quality management reports in accordance with Company procedures.
    • Defines opportunities for improvement through trend analysis and communicates information appropriately.
    • Assists in implementation and monitoring of quality studies including, but not limited to the development and implementation of behavioral health outcomes improvement interventions such as newsletter article, member education and outreach interventions, provider education and outreach interventions, medical record review, focus studies and surveys.
    • Performs monthly, quarterly, annual and ad hoc medical record reviews such as HEDIS and CPG compliance.
    • Conducts quality of care investigations and using criteria closes case appropriately or refers to BH Medical Director for further review.
    • Prepares cases for Peer Review Committee.

    **This position is a hybrid role.  Candidate must be willing to go into the office a minimum of 1-2 days a week.**

    **Monday-Friday 8 am – 5 pm PST**

    **Candidate identified for this role MUST reside in Kentucky or 50 miles from the primary job location**

    Minimum Requirements

    • Requires MS/MA degree in behavioral health or related field and a minimum of 3 years experience in quality improvement and/or behavioral health, risk management and/or utilization review in a managed care setting as well as process improvement; or any combination of education and experience which would provide an equivalent background.

    Preferred Skills, Capabilities, and Experiences:

    • Current unrestricted license, certification in applicable field (i.e. CPHQ) and/or a MS in the health field (i.e. LCSW, LMFT, LPC, LMHC, Ph.D., Psy.D. or a nursing license) with professional behavioral health experience is STRONGLY preferred.)
    • Specific education, type of experience and/or licensure may be required based upon contract requirements and delegated responsibilities.
    • Travels to worksite and other locations as necessary.

     

    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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

    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. 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 elevancehealthjobssupport@elevancehealth.comfor assistance.

  • 2 Days Ago

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Marketing Coordinator Sr
  • Elevance Health
  • KY, KY FULL_TIME
  • Description Location: Elevance Health supports a hybrid workplace model (virtual and in-office) with PulsePoint sites used for collaboration, community, and connection. This includes remote work and 1...
  • 24 Days Ago

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Marketing Research Analyst Sr.
  • Elevance Health
  • KY, KY FULL_TIME
  • Description Location: Elevance Health supports a hybrid workplace model (virtual and in-office) with PulsePoint sites used for collaboration, community, and connection. This includes remote work and 1...
  • 7 Days Ago

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Legal Counsel Sr
  • Elevance Health
  • KY, KY FULL_TIME
  • Description Legal Counsel Sr. Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations in ...
  • 12 Days Ago

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Aerie - Sr Brand Ambassador (Sr Sales Associate) - US
  • Sr Brand Ambassador (Sr Sales Associate) - US - American Eagle Outfitters Careers
  • United States, KY FULL_TIME
  • BE PART OF SOMETHING REAL YOUR ROLE As a part-time Sr Brand Ambassador, you bring our brand to life every day! Your goal is to provide everyone who comes in the store with an amazing shopping experien...
  • 15 Days Ago

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AE - Sr Brand Ambassador (Sr Sales Associate) - US
  • Sr Brand Ambassador (Sr Sales Associate) - US - American Eagle Outfitters Careers
  • United States, KY FULL_TIME
  • BE PART OF SOMETHING REAL YOUR ROLE As a part-time Sr Brand Ambassador, you bring our brand to life every day! Your goal is to provide everyone who comes in the store with an amazing shopping experien...
  • 15 Days Ago

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Insurance Underwriter
  • Calculated Hire
  • PBM Underwriting Analyst Hybrid – Birmingham, AL Overview: The Underwriting Department plays an integral role in support...
  • 3/28/2024 12:00:00 AM

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Specialty A&H Underwriter
  • Axis
  • Princeton, NJ
  • This is your opportunity to join AXIS Capital a trusted global provider of specialty lines insurance and reinsurance. We...
  • 3/25/2024 12:00:00 AM

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Specialty A&H Underwriter
  • Axis
  • Red Bank, NJ
  • This is your opportunity to join AXIS Capital a trusted global provider of specialty lines insurance and reinsurance. We...
  • 3/25/2024 12:00:00 AM

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Specialty A&H Underwriter
  • Axis
  • Chicago, IL
  • This is your opportunity to join AXIS Capital a trusted global provider of specialty lines insurance and reinsurance. We...
  • 3/25/2024 12:00:00 AM

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Specialty A&H Underwriter
  • Axis
  • New York, NY
  • This is your opportunity to join AXIS Capital a trusted global provider of specialty lines insurance and reinsurance. We...
  • 3/25/2024 12:00:00 AM

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Specialty A&H Underwriter
  • Axis
  • Alpharetta, GA
  • This is your opportunity to join AXIS Capital a trusted global provider of specialty lines insurance and reinsurance. We...
  • 3/25/2024 12:00:00 AM

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A&H Underwriter or Senior Underwriter (Hybrid -remote/onsite)
  • Swiss Re
  • Windsor, CT
  • About the Team: As part of the Corporate Solutions (CorSo), North America, Accident & Health Team, you will join a team ...
  • 3/24/2024 12:00:00 AM

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Consultant - Health - 10057
  • SC International
  • Boston, MA
  • Description Client looking to add a Consultant who will manage projects and client relationships spanning a variety of t...
  • 3/24/2024 12:00:00 AM

Kentucky (/kənˈtʌki/ (listen) kən-TUK-ee), officially the Commonwealth of Kentucky, is a state located in the east south-central region of the United States. Although styled as the "State of Kentucky" in the law creating it, (because in Kentucky's first constitution, the name state was used) Kentucky is one of four U.S. states constituted as a commonwealth (the others being Virginia, Pennsylvania, and Massachusetts). Originally a part of Virginia, in 1792 Kentucky became the 15th state to join the Union. Kentucky is the 37th most extensive and the 26th most populous of the 50 United States. Ke...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Health Underwriter, Sr. jobs
$80,745 to $101,380