Alliance Health
Provider Network Evaluator II - Routine Monitoring (Hybrid, Morrisville, North Carolina Based) (Biotech)
The PNE II possesses and maintains clinical licensure and is responsible for conducting monitoring activities to ensure Medicaid beneficiaries are receiving MH/IDD/SUD services as required. The monitoring activities include post payment reviews and clinical quality reviews of those providers in the Alliance Health network. There may be limited instances when the PNE II will assist with targeted reviews and Unlicensed AFL reviews.
This position will allow the successful candidate to work a primarily remote schedule. However, travel is required to conduct on-site reviews and monitoring, at least two days per week.
Responsibilities and Duties
Monitoring of MH/IDD/SUD Providers in the Alliance Health Network
Assist in Department Policies, Procedures, and Standards
Provide Monitoring Information for Inclusion in Provider Database
Maintain Knowledge of Current Services and Supports Available
Travel
Minimum Requirements
Master's degree from an accredited college or university in a Human Services field (such as Psychology, Social Work, etc.) and a minimum of three (3) years post master's degree progressive experience in the field of mental health, developmental disabilities, or substance abuse. Must maintain a valid driver's license and a good driving record.
Must have full, current, and active NC license as an LCSW, LCAS, LCMHC, LPA, or LMFT.
The National Certified Investigator and Inspector Training (NCIT) is preferred, but not required. NCIT must be successfully completed within 6-months of hire.
Knowledge, Skills, and Abilities
Salary Range
$58,480 - $74,562/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: