Alliance Health
Morrisville, NC
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.
This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office (Morrisville, NC) may be required.
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...