Provider Network Evaluator II-Clinical Quality (Full-time Remote, North Carolina Based)

The Provider Network Evaluator II-Clinical Quality performs Clinical Quality Reviews (CQR), Oversight Reviews, and plan of correction implementation reviews of service providers contracted with Alliance Health. Additionally, in limited situations, Provider Network Evaluator II-CQ may investigate instances of concern to ensure individuals receive sufficient, safe, and effective services rendered by providers in the Alliance Health network. This is a hybrid work situation. The PNE II-Clinical Quality Review will work from home. Weekly travel is required to conduct on-site reviews.  The Provider Network Evaluator II-Clinical Quality Review must reside within the following Alliance catchment area counties Cumberland