Remote Care Management Performance Specialist

Alliance Health; Morrisville (NC); Remote; USD 61,000 - 78,000; Full time

Benefits offered by this job

Hybrid/Remote options

Excellent benefits package

Paid time off

Job summary

Alliance Health is seeking a Care Management Performance Optimization Specialist to coordinate data-driven reporting, analytics, and quality assurance across Care Management. You will partner with CM teams and leadership to improve member outcomes and regulatory readiness.

Responsibilities include KPI development, trend analysis, and cross-functional collaboration with SharePoint and Jiva systems. Remote role with occasional on-site visits to Morrisville, NC as needed.

Qualifications

• Bachelor’s degree in Healthcare Administration, Nursing, Public Health, or related field with 3 years in healthcare ops.
• Master’s degree with 1 year of relevant experience may substitute for the Bachelor’s requirement.
• Experience in care management reporting, KPI development, and data analytics is preferred.
• Familiarity with NCQA, EQR, and regulatory readiness is beneficial.

Responsibilities

• Aggregate and finalize CM KPI reports for leadership and stakeholders.
• Perform QA to ensure data accuracy and reporting integrity.
• Collaborate with CM Data Analysts to resolve data issues and definitions.
• Support External Quality Review readiness and regulatory reporting efforts.
• Track trends, identify issues, and assist in process improvements.

Skills

Analytical skills

Data validation

Data interpretation

Communication skills

Education

Bachelor's degree in Healthcare Administration or related field

Master's degree in Healthcare Administration or related field

Tools

SharePoint

Jiva

ServiceNow (SNOW)

Microsoft Office

Job description

Alliance Health is seeking a Care Management Performance Optimization Specialist to coordinate data-driven reporting, analytics, and quality assurance across Care Management. You will partner with CM teams and leadership to improve member outcomes and regulatory readiness.

Responsibilities include KPI development, trend analysis, and cross-functional collaboration with SharePoint and Jiva systems. Remote role with occasional on-site visits to Morrisville, NC as needed.