Provider Network Quality Assurance Specialist (Full-time Remote, North Carolina Based)

The Provider Network Quality Assurance Specialist is responsible for monitoring, auditing, and improving the quality, accuracy, and compliance of provider network operations. The role supports provider data integrity, regulatory compliance, provider directory accuracy, and continuous process improvement.

Responsibilities

& Duties- Conduct Quality Audits of Provider Network Operations Processes

Develop and maintain an audit schedule Conduct research, analyze data, and make recommendations regarding administrative, organizational, and operational problems Maintain audit evidence and records to support internal and external review readiness

Support Provider Directory Accuracy and Provider Data Validation Initiatives

Perform reviews of Provider Directory accuracy and maintain written docume