Elevance Health · 10 hours ago
LTSS Contract Adherence Auditor
Memphis, TN
Contract
Hybrid
Entry, Mid Level
2+ years expElevance Health is a health company dedicated to improving lives and communities, and they are seeking an LTSS Contract Adherence Auditor. This role is responsible for auditing and ensuring contract adherence for the Long Term Services and Supports program, including preparing reports, conducting audits, and maintaining compliance with state laws and contractual requirements.
Health CareHealth InsurancePersonal HealthWellness
Responsibilities
Prepares and ensures completion of internal and external audits, adherence reporting and tracking/monitoring processes as assigned
Audits LTSS work to ensure appropriate and consistent administration of contract requirements
Performs external audits including enrollee record review, new member and short term stay, MCO to MCO, Level of Care and Employment and Community First audits
Responds to on demand state audit requests
Responsible for Annual Quality Survey and Annual Network Audit reviews, audit participation and presents audit results
Provides internal Person Centered Support Plan auditing and comprehensive adherence auditing
Documents audit findings in a timely, accurate and concise manner
Tracks activities such as daily critical incident submissions, short term stay, Individual Experience, Employment and NCI surveys and caseload tracking
Ensures clinical licensure adherence with contract requirements
Completes monthly reports such as short term stay, caseload staffing and ratio reporting
Responds to legislative inquiries and other on demand request per contract agreement
Maintains knowledge of tracking tools and databases, and prepares reports to document contract adherence issues
May educate staff about contract requirements to ensure contract adherence
Participates in projects, initiatives and process improvement activities
May serve as an internal resource, mentor and coach for new associates
Qualification
Required
Requires BA/BS and RN, LPN/LVN, LSW, LCSW, LMSW, LBSW, BSW, or MSW in accordance with applicable state law and minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background
Licensed clinicians hired into this role require current, unrestricted RN, LPN/LVN, LSW, LCSW, LMSW, LPC, or LBSW (as allowed by state law) in applicable state(s)
Preferred
LTSS experience preferred
Computer experience including Microsoft Office Suite including Outlook, Word and Excel preferred
Benefits
Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical
Dental
Vision
Short and long term disability benefits
401(k) +match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Company
Elevance Health
Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.
10001+ employees
H1B Sponsorship
Elevance Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (488)
2024 (604)
2023 (660)
2022 (222)
Funding
Current Stage
Public CompanyTotal Funding
unknown2001-10-30IPO
Leadership Team
Gail K. Boudreaux
President and CEO
Geeta Wilson
Chief Technology Officer (CTO): Digital Health and Service Experience Platforms
Recent News
Inside INdiana Business
2026-02-05
2026-01-25
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