Supervisor, External Clinical Quality Analyst

Alliance Health

. Supervise, coach, and develop a team of licensed clinicians and unlicensed staff performing provider-led Tailored Care Management record reviews .

Posted 9/22/2026full-timeRemote • North Carolina • United StatesMid-LevelSenior💰 $79,425 - $101,267 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare quality oversight, compliance, and Tailored Care Management, with a strong focus on data analysis, performance monitoring, and regulatory adherence. Proven ability to lead and develop teams while fostering a culture of accountability and continuous improvement.

Highest-signal resume keywords

Healthcare Quality OversightRegulatory ComplianceData AnalysisTailored Care ManagementLeadership Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisRegulatory Compliance OversightAudit MethodologiesQuality ReviewsPerformance Metrics MonitoringDocumentation Standards InterpretationHealthcare Documentation InterpretationUtilization ManagementBehavioral Health ComplianceProcess Improvement

Soft Skills

Interpersonal SkillsEffective CommunicationProblem SolvingOrganizational SkillsConflict Resolution

Industry Keywords

Medicaid Managed CareTailored Care Management RequirementsBehavioral HealthHealthcare AdministrationPublic HealthAccreditation StandardsQuality AssuranceStaff DevelopmentPerformance EvaluationsStakeholder Engagement

About the role

Key responsibilities & impact

Supervise, coach, and develop a team of licensed clinicians and unlicensed staff performing provider-led Tailored Care Management record reviews
Establish performance expectations and monitor productivity, quality, and timeliness metrics
Conduct regular staff meetings, performance evaluations, and individual coaching sessions
Provide guidance regarding monitoring processes, documentation standards, and departmental procedures
Foster a culture of accountability, collaboration, continuous improvement, and operational excellence
Oversee the planning, execution, and completion of provider-led Tailored Care Management record reviews
Monitor workflows and staffing assignments to ensure timely completion of deliverables
Review monitoring findings for consistency, accuracy, and adherence to established audit methodologies
Ensure monitoring tools, scoring criteria, and reporting processes are applied consistently across the team
Identify trends, gaps, and opportunities for process improvement based on monitoring results
Ensure monitoring activities comply with applicable federal and state regulations, accreditation standards, organizational policies, and contractual requirements
Collaborate with Sr. Director of Network Evaluation and Compliance Committee to address identified issues and corrective actions
Support preparation for internal and external audits, reviews, and accreditation activities
Monitor changes in requirements and communicate necessary updates to staff and stakeholders
Collaborate with other Tailored Plans, NC DHHS, Practice Transformation, and Sr. Director of Network Evaluation regarding monitoring activities and provider quality improvement
Serve as a subject matter expert on provider-led Tailored Care Management monitoring requirements and standards
Support provider education and technical assistance related to compliance and quality expectations
Participate in regulatory reviews, audits, and accreditation activities
Analyze monitoring data and performance metrics to identify patterns and improvement opportunities
Prepare and present routine and ad hoc reports for leadership
Track monitoring outcomes, corrective actions, and performance indicators
Support organizational quality improvement initiatives through data-driven recommendations
Does not provide direct patient care, make clinical treatment decisions, or serve as a clinical supervisor for licensed staff

Requirements

What you’ll need

Bachelor’s degree from an accredited college or university in public health, healthcare administration, social work, behavioral health, or related field
Six (6) years of experience in behavioral health, healthcare quality, compliance, auditing, care management operations, utilization management, or related healthcare
Two (2) years of leadership, supervisory, or team lead experience preferred
Experience interpreting healthcare/behavioral health documentation and regulatory requirements is required
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
Ability 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
Selected candidate must reside in North Carolina

Benefits

Comp & perks

Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility
An excellent fringe benefit package