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Job description
The Provider Network Evaluator II-Clinical Quality Review performs Clinical Quality Reviews, Oversight Reviews, and plan of correction implementation reviews of service providers contracted with Alliance Health. The selected candidate must reside within the Alliance catchment area counties or live approximately 60 miles from an Alliance office.
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Healthcare
Alliance Health is a public managed-care organization serving over 470,000 Medicaid-eligible and uninsured residents across seven North Carolina counties, coordinating care through a network of more than 4,000 private providers. It administers the Medicaid Behavioral Health and Intellectual/Developmental Disability Tailored Plan, delivering integrated physical, behavioral, and pharmacy services for individuals with complex mental illnesses, substance use disorders, and long-term care needs such as intellectual/developmental disability and traumatic brain injury. The organization’s distinctive approach centers on accountability, integrity, collaboration, compassion, dignity, respect, innovation, and customer service, ensuring that high-quality, patient-centric care meets the unique needs of its communities.