Alliance Health

Manager

• Provide episodic support roles to the members’ multidisciplinary care team.
• Assist with State required assessments.
• Coordinate member follow up care.
• Collaborate with member/guardians and providers to develop discharge plans.
• Facilitate arrangements for and scheduling of transportation, in-home services, and follow-up outpatient visits.
• Conduct post-discharge follow up with member.

Care Manager I – Facility Based

• Provide Transitional Care Management and Physical Health Consultation for members with physical and/or behavioral health needs.
• Active and onsite participation in discharge planning beginning with admission.
• Travel weekly to UNC facilities in Johnston County and Orange County.
• Provide Care Team Support and subject matter expertise regarding member’s physical and/or behavioral health.
• Work collaboratively with other Alliance staff, behavioral health providers, primary care physicians, specialty care providers and other community partners to support members.
• Conduct outreach to the member’s providers and obtain a copy of the discharge plan.
• Assist the member in obtaining needed medications prior to discharge.
• Develop a ninety (90) day post-discharge transition plan prior to discharge from residential or inpatient settings.
• Appropriate escalation of high risk/high visibility and/or complex barriers/needs members.
• Ensure all clinical documentation meet state, agency, and Medicaid requirements.
• Review, validate and interpret risk stratification data and population health groups.

Care Manager II – Facility Based

Analyst

• Supports policy analysis, writing and research activities
• Identifies, obtains, organizes and analyzes data
• Reviews academic and professional literature
• Assists in reviewing state developed clinical coverage policies
• Develops and implements adequate work plans for project improvement activities
• Serves as a resource for medical policy-related questions
• Acts as the department liaison with the internal Communication team

Clinical Planning and Policy Analyst

Research Analyst

• Review and monitor adjudicated claims for file submission and upstream processing
• Communicate with provider agencies on claims submission, denial management, and system updates
• Provide excellent customer service to provider agencies
• Facilitate training of providers and provide intermediate technical assistance
• Review auto-adjudicated claims and manually process claims that pend for manual pricing or high impact criteria
• Analyze available billing requirements, policies, procedures, and desk references to ensure proper protocol is practiced to accurately process claims
• Demonstrate and utilize advanced analytical skills to process complex claims, analyze data, identify system issues, and utilize/build reports to enhance overall unit performance
• Aid in the leadership of the unit through facilitation of meetings, trainings, and process improvement efforts
• Communicate across all departments including Utilization Management, Provider Networks, Finance (Purchasing, Accounts Payable, Accounting), Care Management
• Communicate with external stakeholders including DHHS, DSS, DHB, provider agencies, third-party vendors, and other Managed Care Organizations
• Monitor and resolve technical issues within the Claims system
• Create reports to monitor status of billing, including: paid and denied provider claims; unmanaged and managed service utilization, and consumer or payer-specific reports on claims reimbursement or adjudication

Claims Research Analyst

QA Engineer

• Serve as the project management lead and subject matter expert for NCQA standards
• Manage the assessment of related business functions for corresponding departments
• Implement and monitor accreditation workplan
• Identify gaps and risks and provide regular status reports
• Serve as lead for NCQA Accreditation reviews by gathering necessary documents
• Review and update policies and procedures, reports, and materials for compliance
• Provide technical support and education to staff regarding NCQA Health Plan Accreditation
• Assess business area functions against NCQA standards
• Identify and facilitate process improvements
• Communicate reporting due dates and reminders to business leads
• Lead compliance review for non-clinical standards

NCQA Quality & Accreditation Analyst

Administrative Assistant

• Provide administrative support to the claims team
• Handle high volume incoming and outgoing mail
• Manage high-volume inbound calls
• Complete specific claims-related responsibilities
• Perform a range of clerical tasks
• Maintain databases and spreadsheets
• Conduct research
• Prepare reports
• Handle inquiries
• Receive/screen/keying paper claims
• Develop and/or revise work procedures and methods
• Collect data and research various systems

Administrative Assistant III – Claims

General Counsel

• Perform a full range of legal services in support of Alliance
• Mitigate legal risk through practice in a variety of legal areas
• Provide legal support in contracts including drafting and advising
• Perform legal research and analysis, gather and analyze information
• Represent Alliance in all stages of legal challenges
• Communicate with external stakeholders and support consumer relations
• Stay accessible to Alliance as needed

Assistant General Counsel

• Manage and Develop staff
• Work with Human Resources to attract, maintain, and retain a highly qualified and well-trained workforce
• Ensure staff are well trained in and comply with all organization and department policies, procedures, and business processes
• Organize workflows and ensure staff understand their roles and responsibilities
• Ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements
• Actively establish and promote a positive, diverse, and inclusive working environment that builds trust
• Ensure all staff are treated with respect and dignity
• Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members
• Work to resolve conflicts and disputes, ensuring that all participants are given a voice
• Set goals for performance and deadlines in line with organization goals and vision
• Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional development
• Cultivate and encourage efforts to expand cross-team collaboration and partnership
• Manage Unit operations
• Develop and maintain procedures, and business processes for the working relationships, roles, and responsibilities between Vendor Relations Manager, subject matter experts, vendors, and other key internal Alliance partners
• Implement vendor management processes across the organization, providing guidance to stakeholders, and seeking ways to continually improve the processes
• Along with Organizational Development Team, design and deliver training content for vendor management including day-to-day working guidelines, communication practices, and risk escalation process
• Develop, review, and maintain all enterprise-wide contracts for large vendors serving Alliance members, as well as contracts for Alliance’s value-added services program
• Manage the procurement process from start to finish, including sourcing, negotiation, and contract management
• Conduct market research and analysis to identify new vendors and evaluate their capabilities and pricing
• Monitor vendor performance on the administrative components of the contract and gather performance data on the technical and outcomes components
• Communicate the progress of monthly/quarterly actions and deliverables to internal and external stakeholders
• Monitor changes to Tailored Plan contract requirements including review of weekly Department of Health & Human Services (DHHS) Medicaid Bulletins and released Tailored Plan contract amendments to understand potential impacts to vendor contracts.
• Serve as a non-voting member of the Delegation and Accreditation Oversight Committee (DAOC)
• Review the overall performance of vendors related to required targets and performance metrics prescribed by the Tailored Plan contract
• Build rapport with vendors by understanding the scopes of work and responsibilities, clearly communicating, and identifying reasonable and responsible solutions to potential issues

Manager – Vendor Relations

Learning and Development

• Develop and implement change management strategies and interventions that focus on the people side of change and foster a culture of change readiness
• Facilitate internal employee groups that embrace change, gather feedback on organizational change initiatives and assist in increasing awareness and adoption of change management practices and resistance management plans
• Develop and maintain change management resources and materials, i.e. guides, job-aids, presentations, etc., leveraging internal communication channels, learning platforms and intranet sites
• Develop and facilitate learning and development opportunities to equip employees with the skills and knowledge needed to adapt to and embrace change
• Manage internal communications for change management, that aligns with team and department programs and promote employee awareness, engagement and development
• Lead the Change Champions employee resource group, providing training in change management methodologies and employee engagement drivers, establishing a partnership network that spans across the organization, and fostering collaboration on change and culture initiatives
• Develop evaluations and tools to collect data and monitor the effectiveness of OD programs, surveys and initiatives
• Gather quantitative and qualitative data through various methods such as interviews, focus groups, and observations
• Analyze collected data to identify trends, strengths, gaps, and areas for improvement
• Prepare detailed reports that summarize the evaluation results and provide actionable insights
• Make recommendations for program improvements based on the evaluation findings
• Present findings and recommendations to program managers, leadership, and other stakeholders
• Implement adjustments and recommendations to OD programs, surveys and initiatives; leveraging change management best practices and communication practices
• Work closely within OD Consultant, Employee Engagement and OD Specialist to ensure that change management methodologies are incorporated within all programs and initiatives
• Collaborate within ODL team on the design and delivery of programs and initiatives to support the mission and vision of the department and ensure exceptional customer service delivery
• Provide direct support and coaching to employees to navigate transitions
• Support organizational and department trainings and activities onsite as needed

Organizational Development Specialist II – Change Management

Data Analyst

• Gather and document business and technical needs for data and analytics projects
• Convert needs into analytical specifications and test plans
• Assist in building and validating dashboards, reports, and predictive models
• Safeguard data quality and HIPAA compliance across all analytical solutions
• Elicit and Document Analytics Requirements
• Lead discovery meetings to capture business objectives, key performance indicators (KPIs), and reporting needs
• Capture data source requirements, frequency, granularity, and any service level expectations (e.g., refresh windows)
• Produce requirements artifacts such as Business Requirements Documents (BRDs), data modeling diagrams, and acceptance criteria that define the desired analytics outcomes
• Analyze and Profile Data
• Perform data profiling on source systems (e.g., relational databases, data lakes, SaaS APIs) to understand completeness, consistency, and distribution of fields
• Conduct gap analysis to identify missing attributes or mismatches against reporting specifications
• Document data quality issues, propose validation rules, and define reconciliation procedures that support accurate analytics
• Translate Requirements into Analytical Specifications
• Develop detailed functional and technical specifications for data models, dimensional schemas (star/snowflake), and analytical pipelines (ETL/ELT, data wrangling scripts, BI tool configurations)
• Collaborate with data engineers, data scientists, and BI developers to align design patterns, naming conventions, and reusable components
• Ensure specifications address scalability, security (including HIPAA related data handling), and maintainability of analytical solutions
• Plan and Execute Testing of Analytical Solutions
• Create test plans, test cases, and validation data sets for unit, integration, and user acceptance testing of dashboards, reports, and predictive models
• Support business stakeholders with UAT; log defects, prioritize fixes, and oversee retesting cycles
• Verify performance (e.g., query response time, model runtime) against agreed upon thresholds
• Support Implementation and Ongoing Operations
• Assist with go live activities such as preparation of runbooks, standard operating procedures (SOPs), and cut over checklists for analytics releases
• Monitor initial production runs, perform data reconciliations, and address any discrepancies that arise
• Participate in incident response, root cause analysis, and documentation of lessons learned for continuous improvement
• Maintain Documentation and Knowledge Base
• Keep current inventories of data sources, data dictionaries, lineage diagrams, and model documentation up to date
• Author and refresh end user guides, technical “how to” documents, and metadata catalogs in line with departmental standards
• Translate complex analytical concepts into clear language for both technical and non technical audiences
• Partner with internal business units, external data providers, and vendor teams to ensure alignment on data definitions, delivery schedules, and reporting expectations
• Contribute to data governance initiatives, supporting standards for data stewardship, privacy, and compliance
• Identify opportunities to streamline analytics workflows through reusable templates, automation (e.g., CI/CD pipelines for data models), and self service tooling
• Define and track analytics related KPIs such as report delivery timeliness, data quality error rates, and model accuracy
• Recommend best practice enhancements to increase efficiency, data reliability, and user satisfaction

Data Analytics Business Analyst

Recruitment

• Oversee Talent Acquisition and Compensation Operations
• Plan, direct, and manage talent acquisition and compensation initiatives
• Lead, coach, and develop the Recruiting Manager and Compensation Manager
• Use data and workforce planning insights to drive decision-making
• Advise HR leadership on talent markets, and pay trends
• Optimize recruiting processes and partnerships with hiring managers
• Lead initiatives to achieve the organization’s recruitment metrics
• Conduct market pricing and benchmarking
• Provide guidance and direction on offers, promotions, and pay adjustments
• Identify, develop, and recommend programs, policies/procedures and approaches to meet the needs of employees and the organization
• Maintain compliant processes across recruiting and compensation
• Monitor and ensure compliance with federal, state, and local employment laws and regulations
• Collaborate with peers and leaders to ensure applicable organizational training is conducted for HR programs
• Manage and Develop Staff to attract, maintain, and retain a highly qualified and well-trained workforce.

Director of HR – Talent Acquisition, Compensation

Human Resources

• Oversee Employee Relations and Benefit Operations
• Plan, direct, and manage employee relations and benefits initiatives
• Lead, coach, and develop the Employee Relations Manager and Benefits Manager
• Use data and workforce planning insights to drive decision-making
• Advise HR leadership on benefits strategy, workforce trends, and organizational climate
• Lead initiatives to enhance total health and wellness
• Partner with legal on employee relations and benefits issues impacting the organization
• Identify, develop, and recommend programs, policies/procedures and approaches to meet the needs of employees and the organization
• Analyze and propose modifications to HR policies and procedures
• Represent Alliance at personnel-related meetings, hearings and investigations
• Maintain compliant processes across benefits and employee relations
• Monitor and ensure the organization's compliance with federal, state, and local employment laws and regulations
• Build or enhance employee relations and benefits reports/dashboards
• Collaborate with peers and leaders to ensure applicable organizational training is conducted for HR programs
• Ensure staff are well trained in and comply with all organization policies
• Actively establish and promote a positive, diverse, and inclusive working environment

Director of HR, Employee Relations and Benefits

• Maintain confidentiality with discretion and professionalism.
• Support recruitment efforts by sourcing and screening candidates.
• Provide administrative support, including scheduling and candidate communication.
• Assist with recruitment marketing initiatives, including referral programs and employer branding.
• Contribute to projects such as SOP development, interviewer training, and talent pipeline initiatives.
• Deliver a positive candidate experience through timely and effective communication.

HR Intern, Talent Acquisition

Risk

• Support the Data Governance department in building and maintaining a comprehensive inventory of Alliance Health’s data assets within our Data Governance platform (OpenMetadata).
• Capture and record clear, business‑friendly definitions for data elements, datasets, and data sources.
• Populate and enrich metadata fields (e.g., data lineage, ownership, classification, and security attributes).
• Ensure that the documented information aligns with our established governance policies, standards, and quality criteria.
• Contribute to the creation of searchable, reusable data catalog entries that enable stakeholders across clinical, finance, and operations to discover, trust, and responsibly use our data.

Data Governance Analyst, Student Internship

Security Engineer

• Monitor, Investigate, and Remediate cyber security incidents
• Monitor computer networks for security issues
• Review system alerts and logs
• Investigate IT security and other cyber security incidents
• Identify and mitigate network vulnerabilities and communicate how to avoid them
• Remediate detected vulnerabilities to maintain a high-security standards
• Assist in the development of improved security measures and operate software to protect systems and information infrastructure
• Document security incidents, assess the severity, and report on remediation
• Perform scheduled maintenance audit checklist to include Security Systems (IDS, Firewalls, VPN), Anti-Malware Systems, Email Security, Log management, UBA, User account management, password management and endpoint management
• Deploy security patches
• Perform system security testing
• Perform tests to uncover network vulnerabilities and remediate
• Assist in developing IT security best practices
• Research security enhancements and make recommendations to management
• Assist in Development of company-wide best practices for IT security
• Assist in Audits
• Assist in providing and maintaining evidence for security, state, financial and compliance audits
• Assist IT Personnel with security management
• Provide resource assistance in the implementation of security best practices for business continuity planning, risk management, and disaster planning to senior level management and IT specialists to assist agency's development and maintenance of appropriate business continuity, risk management, and disaster plans
• Assist colleagues with installs of security software and understanding information security management
• Provide Tier 2 support