Onsite Reviewer - North Carolina
$55,120,000–$55,120,000 year
RemoteUnited States
Job Summary
Conduct daily onsite reviews of North Carolina Medicaid providers to verify operations, service delivery, and compliance with state requirements. Independently travel throughout the state to evaluate provider documentation, observe practices, and interview staff using approved checklists and mobile technology. Prepare detailed reports on site visit findings, analyze gathered information for enrollment recommendations, and submit all documentation within established quality assurance deadlines. Manage travel schedules, workloads, and productivity standards while maintaining strict confidentiality of provider information. Represent the organization professionally during all field interactions and address provider concerns to identify process improvements.
Required Qualifications
- Bachelor's degree
- Valid driver's license with an acceptable driving record
- Current automobile insurance
- Ability and willingness to travel extensively throughout North Carolina
- Experience using iPads, tablets, or mobile technology
- Proficiency with Microsoft Office applications
- Strong written communication, documentation, and dictation skills
- Excellent organizational, analytical, and time-management skills
- Ability to work independently with minimal supervision
- Professional demeanor with strong interpersonal, listening, and communication skills
- Honest, dependable, and self-motivated
- Comfortable working independently in a field-based environment
- Detail-oriented with strong investigative and observational skills
- Skilled at analyzing information and making objective recommendations
- Able to manage competing priorities and deadlines
- Customer-focused with excellent problem-solving abilities
- Committed to maintaining confidentiality and professional standards
- Applicants must be authorized to work in the U.S.
Desired Qualifications
- Minimum of two (2) years of experience in one or more of the following areas: Public Health, Critical Care, Home Health, Long-Term Care (LTC), Developmental Disabilities Services, Children's Services, Elder Care Services, Behavioral Health or Mental Health Services, Community Social Services
- Additional experience in one or more of the following areas: Medicaid programs, Provider monitoring or auditing, Third-party billing, Provider training and education, Healthcare compliance, Quality assurance, Healthcare administration
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