Network Auditing Coordinator

TRILLIUM HEALTH RESOURCES•Remote, Remote, US,

11h•$56,270 - $69,898•Remote

About The Position

Trillium Health Resources is seeking a Network Auditing Coordinator to support the development and management of the Provider Network for members with Mental Health, Developmental Disabilities, or Substance Use needs. This role is responsible for overseeing the monitoring activities of the provider network and maintaining knowledge of applicable Federal, State, and Accreditation requirements to ensure organizational compliance.

Requirements

Must meet Qualified Professional (QP) status.
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.
Must have a valid driver’s license.
Must reside within Trillium’s North Central Region, which includes the following counties: Beaufort, Dare, Edgecombe, Greene, Hyde, Nash, Pamlico, Pitt, Tyrrell, Washington, and Wilson.
Must be able to travel within catchment as required.

Nice To Haves

Human Services degree
Licensure/certification may be accepted as noted above

Responsibilities

Maintain network quality by performing provider monitoring to ensure compliance with rules, regulations and service definition requirements.
Facilitate the resolution of deficiencies through the issuance, review and acceptance of Plans of Corrections (POC) and monitoring implementation of these plans.
Establish a partnership and collaboration with Trillium Health Resources Network providers by providing technical assistance/guidance, facilitating communication, and possible inclusion in various committees as necessary.
Conduct quality audits in an objective, systematic, unbiased manner.
Ensure that quality health care determinations are being made based on the provider’s contract/policies and procedures/accreditation standards, as well as federal and state laws/mandates.
Implement and maintain Inter-rater Reliability when conducting reviews.