North Carolina Licensed Clinical Analyst

Job Summary

To enhance quality and compliance, the full-time remote North Carolina Licensed Clinical Analyst will evaluate and monitor staff and provider performance, conduct quality audits, and develop learning solutions based on audit findings.

Key responsibilities

• Conduct quality audits of staff and providers to ensure compliance with regulatory requirements and departmental objectives
• Provide technical assistance and guidance on clinical decision-making aligned with corporate medical policies
• Monitor and report on individual and departmental performance results, including benchmarking and trend analysis

Required qualifications

• RN with 3 years of clinical experience or LPN with 5 years of clinical experience required
• Previous work experience in applicable business areas such as Utilization Management, Case Management, or quality programs
• Bachelor's degree or advanced degree preferred
• Knowledge of clinical quality improvement operations, including HEDIS, strongly preferred
• Experience in conducting patient chart reviews to obtain clinical measures is preferred