Onsite Reviewer

Jobtailor; Winston-Salem (NC); On-site; USD 65,000 - 90,000; Full time

Job summary

Jobtailor in Winston-Salem, NC is seeking a field-based reviewer to assess North Carolina Medicaid providers. You will travel daily across the state, conduct onsite reviews, and interview providers to verify operations and compliance.

You will prepare detailed reports, document findings, and make recommendations on enrollment or continued participation. The role requires a Bachelor's degree, strong communication, and the ability to work independently with minimal supervision.

Qualifications

• Bachelor's degree required.
• Valid driver's license with acceptable driving record.
• Willingness to travel extensively throughout North Carolina.
• Experience using tablets or mobile technology.
• Proficiency with Microsoft Office applications.
• Strong written communication and documentation skills.
• Ability to work independently with minimal supervision.

Responsibilities

• Conduct field-based reviews of North Carolina Medicaid providers.
• Travel daily to Medicaid provider locations throughout North Carolina, with occasional overnight travel.
• Conduct onsite reviews to verify provider operations, service delivery, and compliance requirements.
• Complete North Carolina Medicaid-approved site review checklists and conduct provider interviews.
• Observe, assess, and document provider practices, policies, and procedures.
• Prepare detailed reports documenting site visit findings.
• Submit documentation within established quality assurance and compliance deadlines.
• Analyze review information and provide recommendations regarding provider enrollment or continued Medicaid participation.
• Maintain strict confidentiality regarding provider information and site review findings.
• Meet productivity, quality, and customer service standards.
• Independently manage travel schedules, workloads, timelines, and deadlines.
• Address provider concerns professionally and identify process improvement opportunities.
• Evaluate provider documentation and operational practices for compliance with North Carolina Medicaid requirements.
• Use tablets, Microsoft Office applications, and reporting systems for reviews and documentation.
• Represent SSO professionally during provider interactions.

Skills

Field-based reviews

Public health experience

MS Office proficiency

Strong written communication

Independent work

Organizational skills

Analytical skills

Time-management

Interpersonal skills

Education

Bachelor's degree

Tools

Tablets/Tablets (iPads)

Reporting Systems

Microsoft Office Applications

Job description

• Conduct field-based reviews of North Carolina Medicaid providers
• Travel daily to Medicaid provider locations throughout North Carolina, with occasional overnight travel
• Conduct onsite reviews to verify provider operations, service delivery, and compliance requirements
• Complete North Carolina Medicaid-approved site review checklists and conduct provider interviews
• Observe, assess, and document provider practices, policies, and procedures
• Prepare detailed reports documenting site visit findings
• Submit documentation within established quality assurance and compliance deadlines
• Analyze review information and provide recommendations regarding provider enrollment or continued Medicaid participation
• Maintain strict confidentiality regarding provider information and site review findings
• Meet productivity, quality, and customer service standards
• Independently manage travel schedules, workloads, timelines, and deadlines
• Address provider concerns professionally and identify process improvement opportunities
• Evaluate provider documentation and operational practices for compliance with North Carolina Medicaid requirements
• Use tablets, Microsoft Office applications, and reporting systems for reviews and documentation
• Represent SSO professionally during provider interactions

Requirements

• Bachelor's degree required
• Valid driver's license with an acceptable driving record
• Current automobile insurance
• Ability and willingness to travel extensively throughout North Carolina
• Experience using iPads, tablets, or mobile technology
• Proficiency with Microsoft Office applications
• Strong written communication, documentation, and dictation skills
• Excellent organizational, analytical, and time-management skills
• Ability to work independently with minimal supervision
• Professional demeanor with strong interpersonal, listening, and communication skills
• Minimum of two (2) years of experience in Public Health, Critical Care, Home Health, Long-Term Care (LTC), Developmental Disabilities Services, Children's Services, Elder Care Services, Behavioral Health or Mental Health Services, or Community Social Services
• Additional experience in Medicaid programs, provider monitoring or auditing, third-party billing, provider training and education, healthcare compliance, quality assurance, or healthcare administration preferred

Core Competencies

Demonstrates expertise in conducting field-based reviews and compliance assessments for North Carolina Medicaid providers, utilizing strong analytical and documentation skills. Proficient in managing travel schedules and maintaining confidentiality while ensuring adherence to quality assurance standards.

Highest-signal resume keywords

• Field-Based Reviews
• Compliance Assessment
• Microsoft Office Proficiency
• Strong Written Communication
• Public Health Experience

Hard Skills

• Compliance Requirements
• Provider Monitoring
• Quality Assurance
• Documentation Analysis
• Healthcare Administration

Soft Skills

• Organizational Skills
• Interpersonal Skills
• Time-Management Skills
• Analytical Skills
• Professional Demeanor

Certifications & Qualifications

• Bachelor's Degree
• Valid Driver's License

Industry Keywords

• Medicaid Programs
• Home Health
• Long-Term Care
• Behavioral Health
• Community Social Services

Tools & Technologies

• Tablets
• Microsoft Office Applications
• Reporting Systems