Quality Management Specialist III - Population Health

Trillium Health Resources; Raleigh (NC); Remoto; USD 69.000 - 92.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health Insurance

Flexible Spending Accounts

PTO 24 days + 12 holidays

NC Local Government Retirement Pension

401k with employer match

PSLF qualifying employer

Remote work supplies stipend

Descrizione del lavoro

Trillium Health Resources is seeking a Quality Management Specialist III - Population Health to develop policies and programs that support care management across NC. You will apply clinical expertise to identify rising risk populations, use data informatics, and provide interventions and education to promote prevention and wellness.

The role requires a nursing or health/human services degree and NC licensure, with travel within catchment.

Competenze

• Bachelor’s in Nursing or Master’s in Health/Human Services with related licensure.
• Active NC license: LCSW, LCMHC, LPA, LMFT, LCAS or RN.
• Must reside in North Carolina and have a valid driver's license.
• Must travel within catchment as required.

Mansioni

• Develop, review and evaluate operating policies, practices and procedures with department-wide impact.
• Analyze operations using databases, dashboards and performance data; recommend changes.
• Collaborate with teams to improve workflows for special populations.
• Serve as SME on identified populations, regulatory requirements and program components; provide staff education.
• Oversee resources used for specialty populations and coordinate transportation as needed.

Conoscenze

Policy development

Data informatics

Staff education

Regulatory compliance

Audits/quality improvement

Formazione

Bachelor’s degree in Nursing

Master’s degree in Health or Human Services

Strumenti

Databases

Dashboards

Performance data

Descrizione del lavoro

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

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?

• 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.

What We’re Looking For

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.

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;
• ORMaster’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.

Employee Benefits

• 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) systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook
• 401k with 5% employer match and immediate vesting
• Public Service Loan Forgiveness (PSLF) qualifying employer
• Quarterly stipend for remote work supplies

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.

Deadline for Application

Monday, November 2, 2026 at 11:59pm

EEO Statement

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.