Remote Provider Network Quality Assurance Specialist

Alliance; North Carolina; Hybrid; USD 70,000 - 89,000; Full time

Benefits offered by this job

Generous retirement savings plan

Flexible work schedules includinghybid

Paid time off including vacation, sick

Dress flexibility

Job summary

Alliance seeks a Provider Network Quality Assurance Specialist to monitor, audit, and improve the quality, accuracy, and compliance of provider network operations. This is a full-time remote role with NC residency and occasional onsite travel to Morrisville, NC.

You will lead audits, maintain documentation, validate provider directory data, and ensure regulatory compliance by collaborating across teams to drive data integrity and improvements.

Qualifications

• Five (5) years of quality assurance/improvement experience required.
• Experience leading project teams focused on quality improvement.
• Excel proficiency to analyze data and produce graphs and tables.
• Prior experience in Managed Care preferred.

Responsibilities

• Conduct Quality Audits of Provider Network Operations Processes.
• Develop and maintain an audit schedule.
• Conduct research, analyze data, and make recommendations on problems.
• Maintain audit evidence and records for reviews.
• Support Provider Directory Accuracy and Data Validation initiatives.
• Perform reviews of provider data in systems and documentation.
• Identify discrepancies and route corrections to owners.

Skills

Superior communication

Time management

Stakeholder collaboration

Multi-project management

Education

Bachelor’s degree in Business Administration

Bachelor’s degree in Economics

Bachelor’s degree in Psychology

Bachelor’s degree in Public Health

Bachelor’s degree in Sociology

Bachelor’s degree in Statistics

Tools

Excel

Microsoft Office

MicroStrategy

Job description

Alliance seeks a Provider Network Quality Assurance Specialist to monitor, audit, and improve the quality, accuracy, and compliance of provider network operations. This is a full-time remote role with NC residency and occasional onsite travel to Morrisville, NC.

You will lead audits, maintain documentation, validate provider directory data, and ensure regulatory compliance by collaborating across teams to drive data integrity and improvements.