Provider Network Evaluator I-Targeted Monitoring (Full-time Remote, North Carolina Based)
ALL1034ABHC is hiring for Provider Network Evaluator I-Targeted Monitoring (Full-time Remote, North Carolina Based) in Morrisville, NC. Junior level. First seen October 23, 2026; open as of November 12, 2026. Jobs taken straight from company career pages — no aggregator in between.
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- Company
- ALL1034ABHC
- Where
- Morrisville, NC
- Level
- Junior
- First seen
- October 23, 2026
- Listed via
- UKG
What the posting says
The PNE Targeted Reviewer I is responsible for conducting focused and targeted reviews that may include health and safety reviews, quality of care issues, intensive incident report reviews, the appropriateness of clinical services delivered by providers in the Alliance network. The PNE Targeted Reviewer I is required to review claims data, clinical documentation, provider contracts, policies, and procedures, conduct provider staff and stakeholder interviews, review reference and regulatory materials, to identify out of compliance findings, overpayments, quality of care and health and safety…
Read more and apply on ALL1034ABHC's site
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