Network Auditing Coordinator

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Trillium Health Resources

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🏥 Saúde

💼 Consultoria

📦 Logística

Healthcare • Consulting • Logistics

A Trillium Health Resources é uma gestora líder em cuidados especializados (LME/MCO) para indivíduos com sérios problemas de saúde comportamental, deficiências intelectuais/desenvolvimentais e lesão cerebral traumática na Carolina do Norte. A organização está comprometida em investir na saúde e bem-estar das comunidades que atende, fornecendo serviços como triagens de saúde preventiva, intervenção em crises e gestão de cuidados personalizada. A Trillium foca em melhorar o acesso aos serviços de saúde mental e uso de substâncias para seus membros e garantir apoio para populações vulneráveis.

Descrição

• Maintain network quality by performing provider monitoring to ensure compliance with rules, regulations and service definition requirements. • Facilitate the resolution of deficiencies through the issuance, review and acceptance of Plans of Corrections (POC) and monitoring implementation of these plans. • Establish a partnership and collaboration with Trillium Health Resources Network providers by providing technical assistance/guidance, facilitating communication, and possible inclusion in various committees as necessary. • Conduct quality audits in an objective, systematic, unbiased manner. • Ensure that quality health care determinations are being made based on the provider’s contract/policies and procedures/accreditation standards, as well as federal and state laws/mandates. • Implement and maintain Inter-rater Reliability when conducting reviews.

🎯 Requisitos

• Must meet Qualified Professional (QP) status. • Fully licensed by the NC governing board regulating Human Services professions; • OR Fully licensed RN who is licensed to practice in the state of NC by the NC Board of Nursing who also has four (4) years of full-time experience with the MH/DD/SA population served; • OR A graduate of a college or university with a Master’s degree in a human service field and has one year of full-time, pre or post-graduate degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has one year of full-time, pre or postgraduate degree accumulated supervised experience in alcoholism and drug abuse counseling; • OR A graduate of a college or university with a bachelor's degree in a human service field and has two years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has two years of full-time, pre or post bachelor's degree accumulation supervised experience in alcoholism and drug abuse counseling; • OR A graduate of a college or university with a bachelor's degree in a field other than human services and has four years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has four years of full-time, pre or post-bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling. • Must have a valid driver’s license. • Must reside within Trillium’s North Central Region, which includes the following counties: Beaufort, Dare, Edgecombe, Greene, Hyde, Nash, Pamlico, Pitt, Tyrrell, Washington, and Wilson. • Must be able to travel within catchment as required.

🏖️ Benefícios

• Health Insurance with no premium for employee coverage • Flexible Spending Accounts • 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year • NC Local Government Retirement Pension (defined-benefit plan) • 401k with 5% employer match and immediate vesting • Public Service Loan Forgiveness (PSLF) qualifying employer • Quarterly stipend for remote work supplies