Quality Management Specialist II – IDD

🔥 7 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $56.3k - $69.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

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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

• Monitor Home and Community Based Services (HCBS) Residential, Day Support, and Supported Employment services during members’ plan years • Ensure compliance with the final HCBS rule • Monitor services for compliance with state standards, waiver requirements, and Medicaid regulations • Review service documentation and claims • Promote member satisfaction through ongoing communication and timely follow-up on concerns and issues • Make announced and unannounced monitoring visits to members, including nights and weekends as needed • Monitor services through direct observation, telephonic contact, emails, and other methods in all settings • Work proactively with the Care Management team to ensure quality support and adherence to waiver requirements • Travel within the catchment area as required

🎯 Requirements

• Must meet Qualified Professional (QP) status per NC requirements through one of the listed licensure, RN, master’s degree, or bachelor’s degree and experience 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 experience; or qualifying master’s/bachelor’s degree and specified MH/DD/SA or substance-abuse counseling experience • If serving members with LTSS needs, must additionally have 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 within Trillium’s North Central Region: Beaufort, Dare, Edgecombe, Greene, Hyde, Nash, Pamlico, Pitt, Tyrrell, Washington, or Wilson counties • Must be able to travel within catchment as required • Professional experience focused on individuals with Intellectual Developmental Disabilities (IDD) or Traumatic Brain Injury (TBI) Innovations populations preferred • All candidates must pass a drug test as a condition of employment

🏖️ Benefits

• Collaborative, mission-driven work environment • Competitive benefits • Work-from-home options for most positions • 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

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