Remote Clinical Quality Analyst II: Care Management

Alliance; Charlotte (NC); Hybrid; USD 70,000 - 89,000; Full time

Benefits offered by this job

Generous retirement savings plan

Flexible work schedules includinghybri

Paid time off including vacation, sick

Dress flexibility

Job summary

Alliance is seeking an External Clinical Quality Analyst II for a full-time remote role based in North Carolina. The position requires NC licensure and at least three years of care management experience across populations such as MH/SUD or I/DD, with travel to Home office as needed.

The role focuses on quality reviews, audits, data analysis, and reporting to ensure NCQA and regulatory compliance, along with coaching staff and coordinating training opportunities.

Qualifications

• Experience with care plans, comprehensive assessments, care management interventions, and service engagement activities
• Medicaid Managed Care, or Integrated care (behavioral and physical health)
• Program/services monitoring and evaluation
• Current, active, unrestricted NC clinical license (RN/LCSW/LMHC/LMFT) to practice in NC

Responsibilities

• Analyze Care Management documentation and activities to ensure compliance
• Audit provider-led Care Management policy, procedures, staffing, training, and provision of activities
• Analyze program data to identify trends and develop corrective action plans
• Interpret information to document findings and ensure contractual requirements
• Identify system/operational issues hindering quality standards per NCQA/state/federal rules
• Provide written feedback on quality concerns to leadership
• Evaluate knowledge gaps and coordinate training for staff

Skills

Analytical skills

Strong communication

Problem solving

Time management

Attention to detail

Education

Master’s degree in Health, Psychology, Sociology, Social Work, or related field

North Carolina clinical license (RN/LCSW/LMHC/LMFT/LP A)

Tools

Microsoft Excel

SPSS

SurveyMonkey

Word

PowerPoint

Job description

Alliance is seeking an External Clinical Quality Analyst II for a full-time remote role based in North Carolina. The position requires NC licensure and at least three years of care management experience across populations such as MH/SUD or I/DD, with travel to Home office as needed.

The role focuses on quality reviews, audits, data analysis, and reporting to ensure NCQA and regulatory compliance, along with coaching staff and coordinating training opportunities.