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Program Integrity Auditor (Full-time Hybrid, North Carolina Based)

Alliance Health Plan • Morrisville, NC, US • published 2026-10-13 20:20:26.601324

Description

The Program Integrity Auditor provides detailed analysis, identifies improper payments, recommends corrective action, and strives to mitigate risk through provider education and support. The primary purpose of this position is to audit provider records to ensure that services meet these regulatory standards. Alliance is contractually obligated to implement measures to ensure that services are provided, billed and reimbursed in accordance with rules, regulations, coverage policies, laws, and contract requirements. **This is a full\-time hybrid opportunity. There is no expectation of coming into the office routinely, however, the selected candidate must be available to report onsite to the Home Office for business meetings as needed. The successful candidate will also be required to travel as needed throughout Alliance catchment area and surrounding counties (including ones outside of Alliance’s catchment area) to meet with members, providers, attend court hearing, and/or other community stakeholders.** **Responsibilities \& Duties** Audit/Post\-Payment Reviews/Prepayment Reviews * Conduct routine and targeted post\-payment and prepayment audits of Medicaid and State funded providers...

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