Remote HCBS Provider Network Evaluator

Alliance Health; North Carolina; Remote; USD 35,473 - 45,226; Full time

Benefits offered by this job

Medical, Dental, Vision, Life insurance

Generous retirement savings plan

Flexible work schedules

Paid time off including vacation and sick leave

Job summary

Alliance Health in North Carolina seeks a Provider Network Evaluator I (PNE I) to ensure service compliance for members. This full-time remote position involves reviewing unlicensed service placements and validating self-assessments related to home and community-based services.

The ideal candidate should have a bachelor's degree in a Human Service field and five years of relevant experience in I/DD or TBI services. Strong knowledge of related regulations and high communication skills are essential.

Salary ranges from $25.75 to $32.83 per hour, accompanied by an excellent benefits package including medical, dental, and flexible work schedules.

Qualifications

• Strong knowledge of I/DD and TBI services required.
• Experience with Home Based and Community Services (HCBS) is highly desired.
• Must maintain a valid driver’s license and a good driving record.

Responsibilities

• Validate and approve service site documentation for compliance.
• Perform HCBS reviews within required timeframes.
• Review provider policies for compliance with CMS mandated standards.

Skills

Knowledge of federal and state statutes

Strong mediation skills

Effective communication skills

Microsoft Office skills

Education

Bachelor’s degree in Human Service field

Job description

Alliance Health in North Carolina seeks a Provider Network Evaluator I (PNE I) to ensure service compliance for members. This full-time remote position involves reviewing unlicensed service placements and validating self-assessments related to home and community-based services.

The ideal candidate should have a bachelor's degree in a Human Service field and five years of relevant experience in I/DD or TBI services. Strong knowledge of related regulations and high communication skills are essential.

Salary ranges from $25.75 to $32.83 per hour, accompanied by an excellent benefits package including medical, dental, and flexible work schedules.