Provider Network Specialist II – Adult Behavioral Health

🔥 5 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $56.3k - $69.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🛜 Network Engineer / Network Administrator

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Trillium Health Resources

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Trillium Health Resources is a leading specialty care manager (LME/MCO) for individuals with serious behavioral health, intellectual/developmental disabilities, and traumatic brain injury in North Carolina. The organization is committed to investing in the health and well-being of the communities it serves, providing services such as preventive health screenings, crisis intervention, and tailored care management. Trillium focuses on enhancing access to mental health and substance use services for its members and ensuring support for vulnerable populations.

📋 Description

• Support development and ongoing coordination of the provider network • Engage providers and coordinate onboarding activities • Monitor provider performance to support network readiness, compliance, and access to services • Provide service-specific support and quality monitoring for enhanced services serving adults with SPMI • Apply NC Person-Centered Planning guidance, Clinical Coverage Policy/service definition, and record management standards • Engage providers in onboarding, readiness, and implementation activities • Coordinate provider implementation plans and track progress • Facilitate provider meetings and communication activities • Support resolution of provider performance issues and gaps • Collect, analyze, and report data in a timely and accurate manner • Cultivate collaborative relationships with network providers through technical support and communication outreach • Evaluate monitoring findings and identify compliance issues • Coordinate corrective action plans and monitor implementation • Communicate monitoring results and requirements to providers • Provide guidance supporting compliance and quality outcomes

🎯 Requirements

• High school diploma or GED and six (6) years of experience with medical practices, clinical settings, managed care organizations, provider relations, network development, or provider contracting; OR Associate's degree in a related field and four (4) years of relevant experience; OR Bachelor's degree in a related field and two (2) years of relevant experience; OR equivalent combination of education and experience • Must have a valid driver's license • Must reside within Trillium's Catchment of North Carolina • Must be able to travel within catchment as required • Preferred: One (1) year of work experience in mental health, substance use, or developmental disabilities • Preferred experience with Assertive Community Treatment (ACT), Community Support Team (CST), and/or Transition Management Services (TMS) • Preferred experience developing Person-Centered Plans (PCPs) and understanding NC DHHS Person-Centered Planning guidance • Preferred strong data-driven approach with ability to analyze trends and present findings • Preferred proficiency with Excel and other tools used for data tracking, analysis, and reporting • All candidates must pass a drug test as a condition of employment

🏖️ Benefits

• A collaborative, mission-driven work environment • Competitive benefits and work-from-home options for most positions • Opportunities for professional growth in a diverse inclusive culture • Flexible work schedules available for some positions with management approval • Work-from-home options available for most positions • 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