Alliance Health
Provider Network Evaluator I-HCBS (Full-time Remote, Wake, Cumberland or Harnett County, North Carolina Based) (Personal Services)
The Provider Network Evaluator I (PNE I) is a QP level professional that works as part of the Provider Network Evaluation Department. The department has the responsibility for ensuring that providers are properly delivering services to Alliance members and their families and ensures any out of compliance findings are addressed in a timely manner.
The PNE I position will be assigned to the Home and Community Based Services (HCBS) team. This team is responsible for conducting reviews of Unlicensed Alternatives to Family Living placements for Alliance members and reviews of member self-directed services (Employee of Record) as described in CCP8P, Attachment H. The PNE I will also be involved in ensuring that HCBS final rule requirements are followed, to include ensuring validation of agency self-assessments and that member surveys are remediated when follow up is required.
This position is full-time remote. Selected candidate must reside in North Carolina. Onsite travel is required to conduct reviews and monitoring.
Responsibilities & Duties
Ensure that TBI, Innovation waiver, 1915i, and LTCS (Long Term Care Supports) sites/services are valid to permit members to receive services from a new service location and/or maintain services at an existing site
Review and monitor Individual and Family Directed Services
Assist with department policies, procedures, and standards
Provide monitoring information for inclusion in Provider database
Maintain knowledge of current services and supports available
Participate in investigations and focused reviews
Travel
Knowledge, Skills, & Abilities
Education & Experience
A Bachelor's degree in a Human Service field (such as Psychology, Social Work, etc.) and at least five (5) years of progressive experience in the field of mental health, developmental disabilities or substance abuse.
Strong knowledge of I/DD and TBI services required. Experience with Home Based and Community Services (HCBS) is highly desired.
Special Requirements
Must maintain a valid driver's license and a good driving record.
Salary Range
$25 - $31.88/Hourly
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, Short and Long and Short 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