Carolina Complete Health Network is a vibrant business that engages with providers on behalf of a Medicaid prepaid health plan in North Carolina. The plan we work with, Carolina Complete Health, is the only provider-led entity among the plans in the state’s recently transformed Medicaid system. Our mission is to provide state-of-the-art care to Medicaid beneficiaries, resulting in better health and improved health equity at lower cost.
Reporting to the Director of Medical Policy, the Clinical Advisor will serve as the primary reviewer of Clinical Policies before these are presented to the Medical Affairs Committee and/or Clinical Policy Workgroups. In collaboration with Director of Medical Policy, the Clinical Advisor will be an invaluable resource in assisting to provide clinical feedback on updated/new Clinical Policies. This individual will also assist in identifying data needs specific to Clinical Policies.
Reporting to the Provider Relations Supervisor, the Provider Relations Coordinator is a member of the Provider Relations & Support Team serving as an operational liaison between Medicaid and Marketplace Healthcare Providers, Carolina Complete Health (CCH), Ambetter, Centene and CCHN.
Carolina Complete Health Network is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.