The Provider Support Line Specialist handles calls from providers and answers questions about joining the network, contracts, enrollment, billing, member information, navigating the EHR, claims submissions, authorization requests, onboarding into our network, troubleshooting various technology platforms, and NCTracks. The Provider Helpdesk is open Monday through Saturday 7AM to 6:30PM, Employee schedules may vary to cover the Helpdesk and will in...
The Care Manager l-Non-Waiver assures that individuals and families with special health care needs receive integrated whole-person care management, including coordinating across physical health, behavioral health, pharmacy and unmet health-related resource needs to ensure they are linked to services and supports in an effort to maximize potential outcomes and decrease the unnecessary use of hospitals and emergency services by assuring that approp...
The Supervisor – Utilization Management Physical Health, provides direct oversight of all aspects of Utilization Management as it relates to the management of physical health authorizations, workflows, and processes as well as all aspects of quality improvement activities. This position provides training and coaching for groups individuals, noting achievements and progress when completing individual performance evaluations as well as addressing a...
The Human Resources (HR) Coordinator provides administrative and operational support to the Human Resources team, ensuring smooth and efficient HR processes. This position will support operations of the HR Department including administrative tasks, licensure/certification monitoring, employee offboarding and assisting with employee data management in the Human Resource Information system (HRIS). This position is primarily full-time remote. Select...
The Behavioral Health Crisis Clinician is primarily responsible for conducting telephonic screening, triage and referral functions for individuals seeking services. The Clinician ensures that individuals calling with service needs are safely linked in a timely fashion with available services and/or community resources. The Clinician may also provide crisis service authorizations for both state and Medicaid funded emergency type services. This p...
The Data Analytics Business Analyst gathers and documents business and technical needs for data and analytics projects, converts them into analytical specifications and test plans, assists in building and validating dashboards, reports, and predictive models, and safeguards data quality and HIPAA compliance across all analytical solutions. This position is full-time remote. Selected candidate must reside in North Carolina and be willing to travel...
The Encounter Analyst II is responsible for managing inbound and out bound files in the encounter management workflow, including monitoring and tracking sub-delegate file submissions, and providing insight and assistance with process issues. This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Allia...
The Encounter Analyst II is responsible for managing inbound and out bound files in the encounter management workflow, including monitoring and tracking sub-delegate file submissions, and providing insight and assistance with process issues. This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Allia...
The Director, Artificial Intelligence will lead a team of data professionals responsible for driving the development and implementation of AI/ML solutions that drive business growth, improve operations, and enhance customer experiences. This is a full-time hybrid opportunity. There is no expectation of coming into the office routinely, however, the selected candidate must be available to report onsite to the Alliance Office in Morrisville 1 day p...
This position, overseen by the System of Care Manager, works to support local care coordination efforts through a combination of activities with various public and private agencies, development of processes and agreements to address critical community needs of individuals enrolled with the MCO and foster relationships and partnerships to aid in the identification and referral to the MCO of individuals that meet special needs or high-risk criter...
