Quality Management Specialist II – IDD

🔥 1 minute ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $56.3k - $69.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 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

• Ensure services for members receiving Home and Community Based Services (HCBS) of Residential, Day Support, and Supported Employment are monitored during the member's plan year • Ensure monitoring requirements for Innovations Waiver services are followed • Ensure compliance with the final HCBS rule • Assess and monitor services in coordination with the Care Management team • Monitor services for compliance with state standards, waiver requirements, and Medicaid regulations • Review service documentation and claims • Promote satisfaction with services through ongoing communication and timely follow-up on concerns and issues • Conduct announced and unannounced monitoring visits to members, including nights and weekends as needed • Monitor services through direct observation, telephone contact, email, and other methods in all settings • Travel within the catchment area as required

🎯 Requirements

• Must meet Qualified Professional (QP) status per NC requirements through one of the listed qualification pathways • Fully licensed by the NC governing board regulating human services professions; OR fully licensed RN licensed to practice in North Carolina with four years of full-time MH/DD/SA population experience • Master's degree in a human service field with one year of full-time MH/DD/SA experience, or qualifying supervised substance abuse counseling experience • Bachelor's degree in a human service field with two years of full-time MH/DD/SA experience, or qualifying supervised substance abuse counseling experience • Bachelor's degree in another field with four years of full-time MH/DD/SA experience, or qualifying supervised substance abuse counseling experience • If serving members with LTSS needs, at least two years of prior LTSS and/or HCBS coordination, care delivery monitoring, and care management experience • Must have a valid driver's license • Must reside in North Carolina and within 75 miles of Trillium's Southern Region • Southern Region counties: Bladen, Brunswick, Columbus, Hoke, Lee, Moore, New Hanover, Robeson, and Scotland • Must be able to travel within catchment as required • Must be legally authorized to work in the United States without requiring employment sponsorship now or in the future • Professional experience focused on individuals with IDD or TBI Innovations populations preferred • Experience with IDD Services, monitoring service implementation, and health and safety needs preferred • 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