Tailored Care Management Consultant

Trillium Health Resources; Clayton (NC); Remote; USD 60,000 - 95,000; Full time

Benefits offered by this job

Remote work options

Health insurance – no employee premium

Flexible Spending Accounts

PTO and holidays

NC Local Government Retirement Pension

401k with employer match

Public Service Loan Forgiveness (PSLF)

Stipend for remote work supplies

Flexible work schedules with approval

Job summary

Trillium Health Resources is seeking a Tailored Care Management Consultant to support the quality, compliance, and performance of the Tailored Care Management provider network in North Carolina. The role provides technical assistance, monitoring, and performance oversight to promote compliant, high-quality care delivery.

Remote work within the NC catchment is available, with occasional travel as required to meet program needs and regulatory requirements.

Qualifications

• High school diploma or GED with related work experience.
• Associate's degree in population health, healthcare administration, or a related field with experience in medical practices or managed care.
• Bachelor's degree in population health, healthcare administration, or a related field with experience in provider relations or network development.
• Master’s degree in a relevant health/human services field is preferred.

Responsibilities

• Monitor provider compliance with Tailored Care Management requirements and standards.
• Provide technical assistance and guidance to provider organizations.
• Support development and implementation of corrective action plans.
• Conduct reviews to assess regulatory, contractual, and accreditation compliance.
• Collaborate with stakeholders to improve network performance and quality outcomes.
• Analyze performance data and recommend improvement strategies.

Education

High school diploma or GED

Associate's degree

Bachelor's degree

Master's degree

Job description

Pay Plan Title: Tailored Care Management Consultant Working Title: Tailored Care Management Consultant

Office Location: Remote within Trillium’s catchment area of North Carolina (See requirements section for included counties)

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.

Trillium believes that empowering others begins with supporting our team. Competitive benefits and work-from-home options for most positions

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.

Trillium Health Resources has a career opening for a Tailored Care Management Consultant to join our team! The Tailored Care Management Consultant supports the quality, compliance, and performance of the Tailored Care Management provider network. The role provides technical assistance, monitoring, and performance oversight to support provider compliance and continuous improvement in care management service delivery.

Responsibilities

• Monitor provider compliance with Tailored Care Management requirements and standards.
• Provide technical assistance and guidance to provider organizations.
• Support development and implementation of corrective action plans.
• Conduct reviews to assess compliance with regulatory, contractual, and accreditation requirements.
• Collaborate with internal stakeholders to support network performance and quality outcomes.
• Analyze performance data and recommends improvement strategies.

Benefits

• 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
• flexible work schedules available for some positions with management approval.

High school diploma or GED and six (6) years of experience with medical practices, clinical settings, managed care organizations, provider relations, network development, or provider contracting, including experience leading project plans and overseeing deliverables; Associate's degree in population health, healthcare administration, business administration, health, psychology, sociology, social work, nursing, or another relevant human service area and four (4) years of experience with medical practices, clinical settings, managed care organizations, provider relations, network development, or provider contracting, including experience leading project plans and overseeing deliverables; Bachelor's degree in population health, healthcare administration, business administration, health, psychology, sociology, social work, nursing, or another relevant human service area and two (2) years of experience with medical practices, clinical settings, managed care organizations, provider relations, network development, or provider contracting, including experience leading project plans and overseeing deliverables; Must be able to travel within catchment as required.

Master’s degree in a field related to population health, healthcare administration, business administration, health, psychology, sociology, social work, nursing, or another relevant human service area.