Remote Clinical Quality Evaluator II - Provider Network

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

Benefits offered by this job

Fringe benefits

Hybrid/Remote options

Paid time off

Dress flexibility

Job summary

Alliance Health is seeking a Provider Network Evaluator II-Clinical Quality for a fully remote role based in North Carolina. The job oversees Clinical Quality Reviews, leads teams, and ensures adherence to clinical guidelines and regulatory standards across the Alliance Health network.

The ideal candidate holds a Master’s in Human Services and an active NC license (LCSW/LCAS/LCMHC/LPA/LMFT). Travel to offices and counties as needed is required, with preference for Mecklenburg and nearby counties.

Qualifications

• Master’s degree in Human Services or related field.
• Active NC license as LCSW/LCAS/LCMHC/LPA/LMFT required.
• NCIT certification within 6 months of hire.

Responsibilities

• Conduct Clinical Quality Reviews (MH/IDD/SUD) for Alliance Health providers.
• Lead or participate in case consultation and peer reviews.
• Ensure compliance with clinical guidelines, policies, and regulatory standards.

Skills

Clinical Quality Reviews

Regulatory Compliance

Peer Review Leadership

Team Leadership

Clinical Documentation

Investigation & Analysis

Education

Master’s degree in Human Services

Masters or better in Psychology

NC License: LCSW/LCAS/LCMHC/LPA/LMFT

Job description

Alliance Health is seeking a Provider Network Evaluator II-Clinical Quality for a fully remote role based in North Carolina. The job oversees Clinical Quality Reviews, leads teams, and ensures adherence to clinical guidelines and regulatory standards across the Alliance Health network.

The ideal candidate holds a Master’s in Human Services and an active NC license (LCSW/LCAS/LCMHC/LPA/LMFT). Travel to offices and counties as needed is required, with preference for Mecklenburg and nearby counties.