Posted in Science 30+ days ago.
Type: Full-Time
Location: Morrisville, North Carolina
The External Clinical Quality Analyst II manages the quality review process for provider-led care management programs. Incumbents conduct quality reviews and audits of provider-led care management programs and processes for quality assurance purposes and to support the effective functioning of provider-led care management.
Selected candidate must reside in North Carolina and will be required to travel within the communities Alliance serves at least 3 days per week.
Responsibilities & Duties
Analyze Care Management documentation and activities to ensure compliance
Analyze Data and Report on findings
Evaluate knowledge gaps of staff and coordinate training
Minimum Requirements
Education & Experience
Master’s degree in Health, Psychology, Sociology, Social Work, or another relevant Human Services field from an accredited college/university with a North Carolina Clinical license (LCSW, LCMHC, LMFT, LPA) and three (3) years of experience providing care management to individuals in the following populations; Traumatic Brain Injuries (TBI), Intellectual/Developmental Disabilities (I/DD), Mental Health/Substance Use Disorders (MH/SUD), Severe Mental Illness (SMI), or Physical Health (PH)
Or
Graduation from an accredited school of nursing with a Registered Nurse (RN) license and three (3) years of experience providing care management to individuals in the following populations: Traumatic Brain Injuries (TBI), Intellectual/Developmental Disabilities (I/DD), Mental Health/Substance Use Disorders (MH/SUD), Severe Mental Illness (SMI), or Physical Health (PH)
(3) years of experience providing care management to individuals in the following populations: Mental Health/Substance Use Disorders (MH/SUD), Severe Mental Illness (SMI), Intellectual/Developmental Disabilities (I/DD), Traumatic Brain Injuries (TBI), or Physical Health (PH)
Required Experience
Experience with Care plans, comprehensive assessments, care management interventions, and service engagement activities, or
Medicaid Managed Care, or
Integrated care (behavioral and physical health), or
Program/services monitoring, program evaluation
Special Requirement
Current, active, unrestricted NC clinical license such as RN, LCSW, LMHC, or LMFT to practice as a health professional within the scope of licensure in the state of North Carolina.
Preferred Experience
Auditing Clinical documentation
Preferred Certification
Certified Care Manager (CCM)
Knowledge, Skills, & Abilities
Salary Range
$66,240 - $84,456/Annually
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.
An excellent fringe benefit package accompanies the salary, which includes:
See job description
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