Provider Network Specialist – Senior

Job not on LinkedIn

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $68.9k - $92.1k / year

⏰ Full Time

🟢 Junior

🛜 Network Engineer / Network Administrator

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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 provider network operations and contribute to network strategies that strengthen clinical performance • Collaborate with cross-functional teams to evaluate provider needs and analyze clinical and operational data • Ensure network adequacy, compliance, and effective service delivery • Guide providers on quality, performance standards, and improvement opportunities • Apply clinical expertise to promote high-quality, person-centered care • Contribute clinical insight to network development and management activities supporting provider performance and value-based care models • Address provider performance issues, access barriers, and network gaps through clinical reviews, outreach, and coordinated problem resolution • Align clinical considerations with operational, regulatory, and organizational requirements • Participate in continuous improvement activities related to provider performance, clinical outcomes, network quality, and member access

🎯 Requirements

• Master’s degree • One (1) year of experience in a clinical setting with the MH/SU/IDD population • Active North Carolina licensure as a Licensed Clinical Social Worker (LCSW), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Marriage and Family Therapist (LMFT), Licensed Psychological Associate (LPA), or Registered Nurse (RN) • Valid driver’s license • Must reside within North Carolina • Must be able to travel within catchment as required • All candidates must pass a drug test as a condition of employment • Preferred: Degree in Human Services field • Preferred: Five (5) years of post-Master’s experience in a clinical setting with the MH/SU/IDD population • Preferred: Experience in administrative and operational job duties in clinical setting • Preferred: Certified Professional in Healthcare Quality (CPHQ), Lean Six Sigma Green Belt, and/or Project Management Professional (PMP) or equivalent project management certification

🏖️ Benefits

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