Remote Clinical Quality & Compliance Supervisor

Alliance Health; Morrisville (NC); Remote; USD 79,000 - 101,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Retirement plan

Hybrid/Remote options

PTO & holidays

Dress flexibility

Job summary

Alliance Health in North Carolina seeks a Supervisor-External Clinical Quality Analyst to lead a team of licensed and unlicensed staff in Tailored Care Management record reviews, ensuring accuracy and regulatory compliance.

This full-time remote role requires residence in North Carolina, with occasional travel for onsite Home office meetings. The role emphasizes monitoring, process improvement, and stakeholder collaboration.

Qualifications

• Bachelor’s degree from an accredited college or university in public health, healthcare administration, social work, behavioral health, or related field and six (6) years of relevant experience with two (2) years in leadership preferred.
• Experience interpreting healthcare/behavioral health documentation and regulatory requirements is required.
• Master’s degree in healthcare administration, social work, nursing, public health, or related field and four (4) years of relevant experience preferred.
• Experience with North Carolina Tailored Plans and behavioral health programs is a plus.

Responsibilities

• Lead a team of licensed clinicians and unlicensed staff performing Tailored Care Management record reviews.
• Monitor productivity, quality, timeliness, and conduct regular performance evaluations.
• Oversee planning and execution of provider-led Tailored Care Management record reviews.
• Ensure compliance with federal/state regulations, accreditation, policies, and contracts.
• Collaborate with internal and external stakeholders on monitoring activities and quality improvement.
• Analyze monitoring data and prepare routine and ad hoc leadership reports.
• Support preparation for audits and regulatory reviews.

Skills

Data analysis and reporting

Regulatory compliance

Auditing

Team leadership

Tailored Care Management

Medicaid Managed Care

Quality assurance

Communication

Education

Bachelor’s degree in public health/healthcare administration/social work

Master’s degree in healthcare administration/public health or related field (preferred)

Job description

Alliance Health in North Carolina seeks a Supervisor-External Clinical Quality Analyst to lead a team of licensed and unlicensed staff in Tailored Care Management record reviews, ensuring accuracy and regulatory compliance.

This full-time remote role requires residence in North Carolina, with occasional travel for onsite Home office meetings. The role emphasizes monitoring, process improvement, and stakeholder collaboration.