Quality Management Specialist III - Population Health

TRILLIUM HEALTH RESOURCES; Clayton (NC); Remote; USD 69,000 - 92,000; Full time

Benefits offered by this job

Work-from-home options

Health Insurance with no premium for员工

PTO 24 days + 12 holidays

NC Local Government Retirement Pension

401k with 5% employer match

Public Service Loan Forgiveness (PSLF)

Remote work stipend

Job summary

Trillium Health Resources is seeking a Quality Management Specialist III - Population Health to lead policy development and implement care management interventions for high-risk populations. You will use data informatics to identify gaps and support program goals, collaborating with internal teams across departments to improve workflows and outcomes.

The role requires NC licensure and a valid driver’s license, with remote options within North Carolina.

Qualifications

• Bachelor’s degree in Nursing with 1 year of experience providing care to individuals with complex physical, chronic, and/or behavioral health conditions OR Master’s in Health/Human Services with 1 year of similar experience.
• Fully licensed by NC as LCSW, LCMHC, LPA, LMFT, LCAS or RN.
• Must reside within North Carolina and have a valid driver’s license.
• Must be able to travel within catchment as required.

Responsibilities

• Develop, review and evaluate operating policies, practices and procedures with department-wide impact and provide critical feedback on outcomes.
• Manage, review, and analyze operations for adherence to program goals using data and reports; recommend changes.
• Collaborate with internal teams to identify gaps or opportunities for improved workflows or process changes for special populations.
• Serve as SME regarding identified populations, regulatory requirements, policies, procedures, programs and staff support; provide staff education and training.
• Oversee utilization of resources used by specialty population, e.g. coordination of secure transportation.

Skills

Policy development

Data informatics

Cross-functional collaboration

Education

Bachelor’s degree in Nursing

Master’s degree in Health or Human Services

North Carolina licensure (LCSW/LCMHC/LPA/LMFT/LCAS or RN)

Job description

POSTING DETAILS:

Pay Plan Title: Quality Management Specialist III

Working Title: Quality Management Specialist III - Population Health

FLSA Status: Exempt

Posting Salary Range: $68,890 - $92,138

Office Location: Remote within North Carolina

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:

• 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

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.

If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!

What We’re Looking For

Trillium Health Resources has a career opening for a Quality Management Specialist III - Population Health to join our team! The Quality Management Specialist III - Population Health is responsible for developing policies, procedures, practices, and systems that support the provision of care management services. This role is also responsible for demonstrating clinical expertise for specific complex and/or rising risk member populations and will work to identify members that are appropriate for population health programs utilizing data informatics, along with providing interventions and education to promote health prevention and promotion.

On a typical day, you might:

• Develop, review and evaluate operating policies, practices and procedures with department-wide impact and provide critical feedback on outcomes to enhance effectiveness.
• Manage, review, and analyze operations and services provided for adherence to program goals and objectives utilizing databases, dashboards, performance outcome data and reports. Recommend changes based on analyses.
• Collaborate with internal teams to identify gaps or opportunities for improved workflows or process changes for special populations.
• Serve as a subject matter expert regarding identified special populations, regulatory requirements, policies, procedures, programs and staff support; provide staff education and training on relevant program components.
• Oversee utilization of resources used by specialty population e.g. coordination of secure transportation requests for special populations.

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 with some roles 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

Qualifications

Required:

• Bachelor’s degree in Nursing and one (1) year of experience providing care to individuals with complex physical, chronic, and/or behavioral health conditions; OR
• Master’s degree in a Health or Human Services field and one (1) year of experience providing care to individuals with complex physical, chronic, and/or behavioral health conditions.
• Fully licensed by the state of North Carolina as an LCSW, LCMHC, LPA, LMFT, LCAS or RN.
• Must have a valid driver’s license.
• Must reside within North Carolina.
• Must be able to travel within catchment as required.

Preferred:

• At least one (1) year of clinical policy review, conducting audits, or quality improvement review experience.

Deadline for Application: Thursday, November 12, 2026 at 11:59pm

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