Reviewer

• Conduct field-based reviews of North Carolina Medicaid providers
• Travel daily to Medicaid provider locations throughout North Carolina, with occasional overnight travel
• Conduct onsite reviews to verify provider operations, service delivery, and compliance requirements
• Complete North Carolina Medicaid-approved site review checklists and conduct provider interviews
• Observe, assess, and document provider practices, policies, and procedures
• Prepare detailed reports documenting site visit findings
• Submit documentation within quality assurance and compliance deadlines
• Analyze review information and provide recommendations regarding provider enrollment or continued Medicaid participation
• Maintain confidentiality regarding provider information and site review findings
• Manage travel schedules, workloads, timelines, and deadlines independently
• Address provider concerns and identify process improvement opportunities
• Evaluate provider documentation and operational practices for compliance with North Carolina Medicaid requirements
• Use tablets, Microsoft Office applications, and reporting systems to complete reviews and documentation
• Represent SSO professionally during provider interactions

Reviewer jobs in North Carolina

Onsite Reviewer