Quality Management Specialist II -IDD
About The Position
Trillium Health Resources is hiring a Quality Management Specialist II - IDD to monitor services for members receiving Home and Community Based Services (HCBS), including Residential, Day Support, and Supported Employment. The position ensures that monitoring is conducted during each member’s plan year and that other monitoring requirements for Innovations Waiver services are followed. Its primary focus is compliance with the final HCBS rule. The role requires a proactive approach to assessment and monitoring, and collaboration with the Care Management team to support quality services and consistent adherence to waiver requirements. Monitoring may include reviewing service documentation and claims, direct observation of service delivery, telephonic contact, email, and visits to members in all settings. Visits may be announced or unannounced and may take place at night or on weekends as needed. The specialist also promotes member satisfaction through ongoing communication and timely follow-up on concerns or issues. This position is remote within Trillium’s North Central Region, with travel within the catchment area as required. The region includes Beaufort, Dare, Edgecombe, Greene, Hyde, Nash, Pamlico, Pitt, Tyrrell, Washington, and Wilson counties. Typical working hours are 8:30 a.m. to 5:00 p.m.; flexible schedules may be available for some positions with management approval.
Requirements
- Must meet North Carolina Qualified Professional (QP) requirements through one of the listed pathways: full licensure by the NC board regulating human services professions; RN licensure in North Carolina plus four years of full-time experience with the MH/DD/SA population; a master's degree in a human service field plus one year of qualifying MH/DD/SA experience or supervised substance abuse counseling experience; a bachelor's degree in a human service field plus two years of qualifying experience; or a bachelor's degree in another field plus four years of qualifying experience.
- If serving members with LTSS needs, must also have at least two years of prior LTSS and/or HCBS coordination, care delivery monitoring, and care management experience. This experience may overlap with the experience required for QP status.
- Must have a valid driver's license.
- Must reside in Trillium’s North Central Region: Beaufort, Dare, Edgecombe, Greene, Hyde, Nash, Pamlico, Pitt, Tyrrell, Washington, or Wilson County.
- Must be able to travel within the catchment area as required.
- All candidates must pass a drug test as a condition of employment.
- Applicants must submit an application and resume through the ADP Career Center. The resume must include employer names, service dates by month and year, average weekly hours, essential job duties, education details, and applicable licensure or certification information.
Nice To Haves
- Professional experience focused on working with individuals with Intellectual Developmental Disabilities (IDD) or Traumatic Brain Injury (TBI) Innovations populations.
Responsibilities
- Monitor services for compliance with state standards, waiver requirements, and Medicaid regulations, including reviewing service documentation and claims.
- Promote satisfaction with services through ongoing communication and timely follow-up on concerns and issues.
- Conduct announced or unannounced monitoring visits to members, including nights and weekends as needed.
- Ensure services are monitored as needed in all settings through direct observation, telephone contact, email, and other methods.
- Work with the Care Management team to support quality services and consistent adherence to waiver requirements.
Benefits
- Collaborative, mission-driven work environment.
- Competitive benefits and work-from-home options for most positions.
- Opportunities for professional growth in a diverse, inclusive culture.
- Health insurance with no premium for employee coverage.
- Flexible Spending Accounts.
- 24 days of paid time off (PTO) and 12 paid holidays in the first year.
- NC Local Government Retirement Pension (defined-benefit plan).
- 401(k) with a 5% employer match and immediate vesting.
- Public Service Loan Forgiveness (PSLF) qualifying employer.
- Quarterly stipend for remote work supplies.
- Flexible work schedules may be available for some positions with management approval.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
