External Clinical Quality Analyst II (Full-time Remote, North Carolina Based)

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.

Responsibilities

& Duties- Analyze Care Management documentation and activities to ensure compliance

Review the quality of provider-led Care Management programs by completing administrative reviews is coupled with detailed clinical case reviews for alignment with all requirements identified in the NC DHHS Tailored Care Management Provider Manual. Audit provider-led Care Management polic