Remote Behavioral Health Utilization Review Jobs in Raleigh, NC

This position plans, designs, implements, conducts, and reports program evaluations of services delivered to recipients, including process/implementation evaluation, outcome evaluation, and cost benefit analysis.  Ensures that services delivered are consistent with funding requirements, best practices, provider contracts and federal/state rules and regulations.  Utilizes both qualitative and quantitative evaluation methods.  Interprets data, analyzes results using statistical techniques and assures that results are disseminated in written and oral formats in a manner that promotes continuous quality improvement.  Reviews and synthesizes existing research and evaluation information on priority topics for Alliance to ensure programs and service decisions are informed and guided by research, including appropriate expectations about return on investment for programs, and identification of promising alternatives for underperforming services.

This position is a provisional appointment that is tied to recurring funding. The extension of the position past June 2027 is dependent on ongoing funding.

This position is remote. The selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office may be required. 

Responsibilities & Duties

Design Evaluation Projects Based on Program Plans

• Establishes provider performance and service outcome measures, collects and analyzes performance information; plans and manages evaluations
• Develops, designs, and implements evaluation projects based on sound and valid research methods and statistical techniques
• Designs and implements evaluations and focused studies that address immediate concerns, identifies root causes of concerns, writes summary of findings/recommendations, and communicates to Alliance departments and/or providers as needed
• Reviews existing data, literature research, and a review of pertinent Web sites and other Internet-accessible materials to gather information that will facilitate understanding of the program or activity to be reviewed and to identify the criteria applicable to the evaluation of the program or activity

Conduct all Aspects of the Evaluation Projects Within Timelines

• Acquires data from primary and secondary data sources and maintains data sets for ongoing data analysis
• Evaluates the quality of service provided to the MCO and develops, measures, and analyzes provider outcomes consistent with research and expected results
• Reviews and analyzes data on service fidelity, service implementation processes and quality of services
• Implements established process and outcome monitoring methodologies
• Identifies, analyzes, and interprets trends or patterns in complex data sets
• Performs all aspects of data analysis

Write and Deliver Briefings, Presentations, Summaries and Reports of Findings and Recommendations

• Prepares accurate reports documenting findings, and ensuring adequate documentation and methodology to support findings and recommendations
• Creates professional charts, data reports, and presentations related to assigned data/evaluation/research projects
• Facilitates communication of data with internal and external stakeholders
• Assists in developing and delivering instructional materials and providing technical assistance related to evaluation studies, quality reviews, data analysis, and reporting, as requested

Inter-departmental Collaboration to Promote use of Evaluation Processes and Results in a Way that Promotes Continuous Quality Improvement

• Participates in internal committees as assigned, creates, and delivers presentations that are clear and complete
• Develops and maintains professional and positive working relationships with all Alliance departments, contracted network providers, and stakeholders

Minimum Requirements

Education & Experience

Required:

Bachelor’s degree in sociology, economics, psychology or related social science from an accredited college or university and two (2) years post degree, progressively responsible experience in gathering, editing, and analyzing data for social and economic research, including experience directly related to data analysis and research evaluation or statistics. 

Preferred:

Professional with at least five (5) years of experience in the field of behavioral health, and statistics, program evaluation or quality management.  

Knowledge, Skills, & Abilities

•  Strong analytical skills with the ability to collect, organize, and analyze data using statistical techniques with attention to detail
• Proficiency in evaluation methods and techniques
• Strong quantitative and qualitative data analysis skills
• Expert written and oral communication skills
• Strong data visualization and infographic reporting
• Experience with statistics and experience using statistical packages for analyzing datasets (Microsoft Access, SQL)
• Proficiency in advanced functions of Microsoft Office Excel
• Advanced skills in Word, PowerPoint, and data visualization
• Knowledge of best and promising practices for behavioral health and/or intellectual/developmental disabilities

Salary Range

$61,439 - $79,871/ Annually