Practice Transformation Specialist

Alliance Health

. Support network providers in evolving administrative and clinical workflows and processes to improve outcome-based care .

Posted 9/17/2026full-timeNorth Carolina • United StatesMid-LevelSenior💰 $69,592 - $88,729 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare quality improvement, data-informed care management, and effective communication with providers. Proficient in utilizing performance metrics and analytics to enhance care delivery and operational efficiency.

Highest-signal resume keywords

Healthcare Quality ImprovementData Analysis and ReportingProject ManagementPublic Speaking and Presentation DevelopmentKnowledge of HEDIS Metrics

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Health Information TechnologyPDSA Process ImprovementData AnalysisCPT CodingICD CodingHCPCS CodingMicrosoft Office ProfessionalPivot TablesPareto AnalysisRisk Adjustment

Soft Skills

Excellent Communication SkillsInterpersonal SkillsDetail-OrientedOrganizational SkillsCustomer Service Skills

Tools & Technologies

JIVANCCARES 360InovalonSiftwell’s PegasusMicroStrategy

Industry Keywords

Managed CarePopulation HealthSocial Determinants of HealthClinical IntegrationQuality Metrics

About the role

Key responsibilities & impact

Support network providers in evolving administrative and clinical workflows and processes to improve outcome-based care
Assist care management providers with site billing setup, claims processing, data-informed care management, interventions, workflows, policies, and procedures
Educate practices and clinically integrated networks (CINs) on continuous quality improvement principles, interventions, PDSA cycles, and data-driven care
Review performance reports, panel and engagement rates, quality dashboards, gaps in care, medical economics dashboards, emergency department visits, utilization, and other performance data with providers and CINs
Present data in an understandable format to drive improved member care
Collaborate with AMHs and CMAs to integrate administrative, financial, and clinical systems and data
Conduct gaps analysis and use the Gaps Analysis and CQI Rubric to strengthen care management entity performance
Facilitate agency adoption of 1915(i) processes and impacts of HR.1 and other state programs
Deliver practice-level education, training, and toolkits covering HEDIS measures, Alliance initiatives, and state requirements
Educate providers on JIVA, NCCARES 360, Inovalon, Siftwell’s Pegasus, Medical Economics dashboards, and MicroStrategy reports
Provide customized coaching at clinical sites to identify needs, prioritize focus areas, and use data for care management and alternative payment models
Create and deliver presentations on data-informed care management, value-based contracting, CQI, and alternative payment models
Produce reports on quality, financial, and utilization goals and share quality and clinical outcomes
Support implementation of provider-led care management and ensure fidelity to the care model
Create sustainability tools, address implementation barriers, propose solutions, and guide clinical staff and leadership on best practices
Assist providers with panel management and understanding panel assignments
Create project plans, toolkits, training materials, user education, and evaluation materials with interdisciplinary teams
Collaborate with Quality Management, Provider Network Evaluation, Care Management, Finance, IT, and Care Management Liaison departments
Communicate file and data-source changes to providers and resolve member-facing barriers, issues, and concerns

Requirements

What you’ll need

Bachelor’s degree in nursing, social work, or another human services-related field
Five (5) years of post-degree experience in healthcare or managed care
Experience leading healthcare quality and process improvement initiatives in an operational setting, particularly within community health, preferred
Experience in public speaking, mediation, presentation development, training, group facilitation, advocacy, regulatory compliance, and project management preferred
Understanding of Health Information Technology (HIT)
Knowledge of lean or PDSA process improvement fundamentals
Moderate analytic knowledge, including pivot tables, Pareto analysis, data errors, risk adjustment, price/volume variance analysis, benchmarks, and coefficient of variance
Understanding of quality, utilization, and financial metrics, specifically HEDIS
Knowledge of population health, social determinants of health, and clinical integration
Moderate project management skills, including mapping dependencies and identifying critical path
Proficiency in Microsoft Office Professional products and PowerPoint
Customer service principles and effective listening skills
Detail-oriented and highly organized
Ability to work independently and make strategic decisions
Ability to prioritize workload for on-time project completion
Excellent verbal and written communication, interpersonal, analytic, and customer service skills
Ability to use data to drive change and present performance data to providers
Ability to work effectively on simultaneous projects with competing priorities
Ability to function collaboratively in a team-based work environment
Ability to generate trust and build collaborative relationships internally and externally
Knowledge of CPT, ICD, and HCPCS coding

Benefits

Comp & perks

Primarily remote work schedule
No routine office attendance expected
Opportunity to work on interdisciplinary teams and cross-department projects