OPT Clinical Auditor Jobs
Clinical Auditor roles review medical records, billing codes, and compliance documentation, making them a strong fit for F-1 OPT students with healthcare administration or health informatics degrees. Most positions qualify as STEM OPT extensions under CIP codes like 51.07 or 51.99, giving you up to 36 months of authorized work.
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Get Access To All JobsAnticipated End Date:
2026-06-06
Position Title:
Behavioral Health Clinical Auditor
Job Description:
Behavioral Health Clinical Auditor
Location:
It is highly preferred that the selected candidate reside within commutable distance to a PulsePoint.
Virtual:
This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
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.
The Behavioral Health Clinical Quality Audit Analyst will be responsible for conducting NCQA related clinical file reviews and developing, coordinating, implementing, and evaluating quality improvement activities including data and outcome measurements for clinical and quality programs and interventions.
How you will make an 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.
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:
- Experience with NCQA standards, specifically file reviews.
- 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.
For candidates working in person or virtually in the below locations, the salary range for this specific position is $34.14/hr to $53.54/hr.
Locations: Colorado, Illinois, Massachusetts.
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Job Level:
Non-Management Non-Exempt
Workshift:
1st Shift (United States of America)
Job Family:
MED > Clinical Quality (Non-Licensed)
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 elevancehealthjobssupport@elevancehealth.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.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.
Anticipated End Date:
2026-06-06
Position Title:
Behavioral Health Clinical Auditor
Job Description:
Behavioral Health Clinical Auditor
Location:
It is highly preferred that the selected candidate reside within commutable distance to a PulsePoint.
Virtual:
This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
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.
The Behavioral Health Clinical Quality Audit Analyst will be responsible for conducting NCQA related clinical file reviews and developing, coordinating, implementing, and evaluating quality improvement activities including data and outcome measurements for clinical and quality programs and interventions.
How you will make an 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.
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:
- Experience with NCQA standards, specifically file reviews.
- 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.
For candidates working in person or virtually in the below locations, the salary range for this specific position is $34.14/hr to $53.54/hr.
Locations: Colorado, Illinois, Massachusetts.
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Job Level:
Non-Management Non-Exempt
Workshift:
1st Shift (United States of America)
Job Family:
MED > Clinical Quality (Non-Licensed)
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 elevancehealthjobssupport@elevancehealth.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.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.
See all OPT Clinical Auditor Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new OPT Clinical Auditor Jobs.
Get Access To All JobsTips for Finding OPT Sponsorship as a Clinical Auditor
Confirm your degree qualifies for STEM OPT
Health informatics, health services administration, and clinical data science degrees commonly qualify for the 24-month STEM OPT extension. Verify your CIP code with your DSO before applying so you know your total authorized work window upfront.
Target healthcare systems with compliance departments
Large hospital networks, insurance companies, and government health contractors employ full audit teams and have HR infrastructure for OPT authorization. Smaller private clinics rarely have the administrative capacity to support work authorization paperwork.
Frame your clinical coursework as audit experience
Courses covering ICD-10 coding, HIPAA compliance, or healthcare quality management translate directly to audit responsibilities. List these explicitly in your resume so hiring managers recognize your technical foundation without needing to connect the dots themselves.
Obtain a CPC or CRC credential before applying
A Certified Professional Coder or Certified Risk Adjustment Coder credential signals technical competency to employers unfamiliar with OPT. It shortens conversations about your qualifications and shifts focus toward your value rather than your visa status.
Apply to OPT-authorized roles before your grace period starts
Clinical audit hiring cycles often take six to ten weeks from application to offer. Starting your search three to four months before your program end date gives you time to receive and accept an offer while your current status is still active.
Disclose OPT status early and factually in recruiter conversations
State your OPT end date, whether you qualify for STEM extension, and that no employer petition is required during OPT. Recruiters unfamiliar with OPT often confuse it with H-1B visa sponsorship, and a clear one-sentence explanation prevents early disqualification.
Clinical Auditor OPT: Frequently Asked Questions
Do Clinical Auditor jobs qualify for the STEM OPT extension?
Many Clinical Auditor positions do qualify, but it depends on your specific degree. Health informatics, health data analytics, and clinical data science programs typically carry STEM-designated CIP codes. Healthcare administration degrees without a quantitative focus may not qualify. Check your program's CIP code with your DSO before assuming you're eligible for the 24-month extension.
Do employers need to sponsor me to work as a Clinical Auditor on OPT?
No. During your initial OPT and STEM OPT extension periods, your employer does not file any visa petition on your behalf. You work on your F-1 status with EAD authorization. For STEM OPT, your employer must be E-Verify enrolled and sign a formal training plan, but that is not visa sponsorship in the H-1B sense.
Where can I find Clinical Auditor jobs that are open to OPT candidates?
Migrate Mate is built specifically for F-1 OPT and international students and filters for roles where employers are willing to work with OPT authorization. Searching there saves time compared to applying broadly and discovering visa restrictions late in the process. You can filter by role type and work authorization to surface relevant Clinical Auditor openings.
What degree fields do employers typically expect for Clinical Auditor roles?
Most employers want a background in health information management, health informatics, nursing, or healthcare administration. Some positions in billing-focused audit accept candidates with business degrees plus coding credentials. The closer your coursework aligns to ICD coding, compliance, or quality management, the stronger your application regardless of the exact degree title.
Can I work as a Clinical Auditor remotely on OPT?
Yes. Remote work is permitted on OPT as long as the employment is bona fide and within the scope of your authorized field of study. For STEM OPT specifically, your employer still needs to maintain E-Verify enrollment and your training plan must document how the remote role provides practical training relevant to your degree. Update your DSO if your work location changes significantly.