Quality Management Specialist II (NE) - IDD

Trillium Health Resources; United States; Remoto; USD 56.000 - 70.000; Tempo pieno

Vantaggi offerti da questo lavoro

Work-from-home options

Health insurance with no premium for员工

Flexible Spending Accounts

Paid Time Off 24 days + 12 holidays

401k with 5% employer match

PSLF qualifying employer

Remote work stipend

Descrizione del lavoro

Trillium Health Resources seeks a Quality Management Specialist II - IDD to monitor HCBS services and innovations waiver adherence during the member’s plan year. Focus is on HCBS final rule compliance and collaborative work with Care Management for quality support.

The role requires proactive assessment, monitoring, and coordination with the team to ensure waiver requirements are met, with potential travel within NC as needed.

Competenze

• Must meet Qualified Professional (QP) status per NC requirements.
• Must reside in North Carolina within 75 miles of Trillium’s Southern Region.
• Must be legally authorized to work in the United States without sponsorship now or in the future.
• Must have a valid driver’s license.

Mansioni

• Monitor services for compliance with state standards, waiver requirements, and Medicaid regulations.
• Promote satisfaction with services through ongoing communication and timely follow-up on concerns.
• Make announced/unannounced monitoring visits to members, including nights/weekends as needed.
• Ensure that services are monitored as needed in all settings (direct observation, telephonic contact, emails, etc.).

Conoscenze

QP status

Driver's license

Travel willingness

Formazione

RN licensure in NC

Master’s degree in a human services field

Bachelor’s degree in a human services field

Bachelor’s degree in a non-human-services field with 4 years MH/DD/SA experience

Bachelor’s degree in a non-human-services field with 4 years of relevant experience

Descrizione del lavoro

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Quality Management Specialist II (NE) - IDD

Plan Based Care Management Full Time Professionals *Trillium office based location as specified below: US 2 Attachments

Salary Range: $56,270.00 To $69,898.00 Annually

Pay Plan Title: Quality Management Specialist II (NE)

Working Title: Quality Management Specialist II - IDD

Cost Center: 8500/Plan Based Care Management

FLSA Status: Non-Exempt

Posting Salary Range: $56,270 - $69,898

Office Location: Remote in North Carolina and within 75 miles of Trillium’s Southern Region (See requirements section for included counties)

POSTING DETAILS:

Make an Impact

Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.

Why Work for Us?

Trillium believes that empowering others begins with supporting our team. We offer our employees:

• Competitive benefits and work-from-home options for most positions
• Opportunities for professional growth in a diverse inclusive culture

Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.

What We’re Looking For

Trillium Health Resources has a career opening for a Quality Management Specialist II - IDD to join our team! The Quality Management Specialist II - IDD is responsible for ensuring that services for members who receive Home and Community Based Services (HCBS) of Residential, Day Support, and Supported Employment are monitored based on the HCBS requirements during the member’s plan year, as well as ensuring other monitoring requirements for Innovations Waiver services are adhered to. The focus of this position is to ensure compliance with the final HCBS rule. This position requires a dynamic, proactive approach to assessment, monitoring, and working with the Care Management team to ensure quality support and consistent adherence to waiver requirements.

On a typical day, you might:

• Monitor services for compliance with state standards, waiver requirements, and Medicaid regulations, as applicable (including review of service documentation, review of claims, etc.).
• Promote satisfaction with services through ongoing communication and timely follow-up on any concerns/issues.
• Make announced/unannounced monitoring visits to members, including nights/weekends as needed
• Ensure that services are monitored as needed (including direct observation of service delivery, telephonic contact, emails, etc.) in all settings.

Employee Benefits:

Trillium knows that work/life balance is essential. That’s why we offer:

• Typical working hours: 8:30 am – 5:00 pm; 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
• 401k with 5% employer match and immediate vesting
• Public Service Loan Forgiveness (PSLF) qualifying employer
• Quarterly stipend for remote work supplies

Qualifications

Required:

• Must meet Qualified Professional (QP) status per NC requirements through one of the following:
  • 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 accumulated 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.
• Additionally, if serving members with LTSS needs, must meet the minimum QP requirements defined above and shall additionally have at a minimum two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience. This experience may be concurrent with the years of experience required to become a Qualified Professional.
• Must have a valid driver’s license.
• Must reside in North Carolina and within 75 miles of Trillium’s Southern Region, which includes the following 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 sponsorship for employment now or in the future (ex: OPT F-1, J-1).

Preferred:

• Licensure/certification may be accepted as noted above.
• Professional experience focused on working with individuals with Intellectual Developmental Disabilities (IDD) or Traumatic Brain Injury (TBI) Innovations populations.
• Experience with IDD Services, monitoring service implementation, and Health and safety needs.

Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.

#Innovation #Technology #Careers #NorthCarolina #BehavioralHealth

Attachments (2)

Tips for Applying to or Interviewing with Trillium 10.9.26.pdf

GOVCL011 - Quality Management Specialist II (NE) (1).pdf