Alliance Health Tech Stack
Medicaid managed care organization serving 470K members across NC counties
Alliance Health operates a Medicaid managed care plan across seven North Carolina counties, managing physical, behavioral, and pharmacy care for 470,000 members with complex needs. The tech stack is enterprise-heavy (SQL Server, Salesforce, ServiceNow, MicroStrategy) paired with Microsoft automation tools (Power Automate, SharePoint Framework), and the hiring profile is heavily skewed toward healthcare operations (16 of 28 open roles) rather than engineering—reflecting a compliance and claims-processing-driven organization. Active projects focus on HEDIS reporting, claims workflows, and provider network management, while pain points cluster around compliance gaps, claims performance, and data quality.
Tech Stack 14 technologies
What Alliance Health Is Building
◆Challenges
- Gaps in services
- Out of compliance findings
- Provider compliance monitoring
- Compliance risk mitigation
- Improving hedis ratings
- Streamlining claim workflows
- Improving claims processing performance
- Compliance with network adequacy standards
- Data integrity and quality assurance
- Automation of reporting processes
▲Active Projects
- Plan of correction implementation
- Failover planning and system resiliency testing
- Quality indicator development
- Hedis data reporting platform
- Geocoding spatial analysis for hedis metrics
- Claims adjudication rule development
- Environment migration
- Network adequacy reporting
- Provider database maintenance
- Develop monitoring policies for behavioral health and idd services
Hiring Activity
Department
Seniority
Notable leadership hires: Medical Director
