Remote KPI-Driven Care Management Specialist

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

Benefits offered by this job

Generous retirement savings plan

Flexible work schedules including híbr

Hybrid/Remote options

Paid time off (vacation, sick, holiday

Dress flexibility

Job summary

Alliance Health Plan is hiring a Care Management Performance Optimization Specialist to support data-driven reporting and performance improvement across Care Management. The role emphasizes KPI development, data validation, and cross-functional collaboration while ensuring regulatory readiness and high-quality care outcomes.

The position is full-time and remote, with the candidate residing in North Carolina and willing to travel to the Morrisville home office for onsite meetings as needed.

Qualifications

• Bachelor’s degree in Healthcare Administration, Nursing, Human Services, Public Health, Business Administration, Data Analytics, or related field with three years of healthcare operations, care management, population health, quality improvement, project coordination, reporting, or data analysis.
• Or Master’s degree in a related field with one year of relevant experience.

Responsibilities

• Aggregate, validate, and finalize CM KPI reports for leadership and stakeholders.
• Perform QA to ensure data accuracy and alignment with reporting obligations.
• Collaborate with CM Data Analyst teams to resolve data issues and definitions.
• Provide analytical support for operational workstreams and projects.
• Support NCQA readiness and Model of Care implementation with cross-functional teams.
• Track trends and mitigate issues; coordinate with QA and document control.

Skills

Analytical skills

Data validation

Data interpretation

Report development

Communication skills

Project coordination

Workflow design

Cross-functional collaboration

Care management operations knowledge

Microsoft Office / SharePoint

Education

Bachelor’s degree in Healthcare Administration

Master’s degree (related field)

Tools

SharePoint

Jiva

ServiceNow (SNOW)

EQR/NCQA reporting

Job description

Alliance Health Plan is hiring a Care Management Performance Optimization Specialist to support data-driven reporting and performance improvement across Care Management. The role emphasizes KPI development, data validation, and cross-functional collaboration while ensuring regulatory readiness and high-quality care outcomes.

The position is full-time and remote, with the candidate residing in North Carolina and willing to travel to the Morrisville home office for onsite meetings as needed.