The Supervisor-External Clinical Quality Analyst oversees a team of licensed and
non-licensed staff responsible for conducting quality assurance, compliance, and
documentation reviews of provider-led Tailored Care Management records. The
Supervisor-External Clinical Quality Analyst role ensures monitoring activities
are completed accurately, consistently, and in accordance with organizational
standards, regulatory requirements, accreditation standards, and contractual
obligations. The Supervisor-External Clinical Quality Analyst provides
operational leadership, performance management, workflow oversight, training,
and coaching to team members, identifies opportunities for improvement, and
collaborates with internal and external stakeholders to ensure successful
delivery of provider-led Tailored Care Management services. The
Supervisor-External Clinical Quality Analyst does not provide direct patient
care, make clinical treatment decisions, or serve as a clinical supervisor for
licensed staff.
This position is full-time remote. Selected candidate must reside in North
Carolina. Some travel for onsite meetings to the Home office may be required.
Responsibilities & Duties
Team Leadership and Management
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
Audit Operations
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
Quality and Compliance
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
Stakeholder Collaboration
Partner and collaborate with other Tailored Plans, NC DHHS, Practice
Transformation and Sr. Director of Network Evaluation regarding monitoring
activities and quality improvement for providers
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
Data Analysis & Reporting
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
Minimum Requirements-
Education & Experience
Required:
Bachelor’s degree from an accredited college or university in public health,
healthcare administration, social work, behavioral health, or related field and
six (6) years of experience in behavioral health, healthcare quality,
compliance, auditing, care management operations, utilization management, or
related healthcare with two (2) years of leadership, supervisory, or team lead
experience preferred.
Experience interpreting healthcare/behavioral health documentation and
regulatory requirements is required.
Preferred:
Master’s degree in healthcare administration, social work, Nursing, Public
Health, or related field and four (4) years of experience in care management,
quality management, compliance, healthcare operations.
Experience with North Carolina Tailored Plans and behavioral health programs
preferred.
Knowledge, Skills, & Abilities
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. Able
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.
Salary Range
$79,425 -$101,267/ 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:
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