Supervisor-External Clinical Quality Analyst (Full-time Remote, North Carolina B

Required:

Bachelor’s degree from an accredited college or university in public health, healthcare administration, social work, behavioral health, or related field and six (6) years of experience in behavioral health, healthcare quality, compliance, auditing, care management operations, utilization management, or related healthcare with two (2) years of leadership, supervisory, or team lead experience preferred.

Experience interpreting healthcare/behavioral health documentation and regulatory requirements is required.

Master’s degree in healthcare administration, social work, Nursing, Public Health, or related field and four (4) years of experience in care management, quality management, compliance, healthcare operations.

Experience with North Carolina Tailored Plans and behavioral health programs preferred.

• Demonstrated experience in data analysis, reporting, and regulatory compliance oversight
• Ability to interpret complex datasets and ensure data integrity
• Knowledge of Medicaid Managed Care and Tailored Care Management requirements
• Experience conducting audits, monitoring, or quality reviews
• Strong analytical, organizational, and problem-solving skills
• Precision in reviewing documentation, reports, and compliance metrics. Able to independently organize multiple tasks and priorities, and effectively manage under pressure of deadlines
• Strong ability to build partnerships with internal and external stakeholders. Exceptional interpersonal skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts
• Excellent written and verbal communication for reports, audits, and stakeholder engagement
• Ability to supervise, motivate, train and instruct staff. Problem solving and conflict resolution skills are essential
• Strong understanding of quality assurance and audit methodologies.