Quality Management Specialist III - Population Health
About The Position
Trillium Health Resources is hiring a Quality Management Specialist III - Population Health to develop policies, procedures, practices, and systems that support care management services. The position demonstrates clinical expertise for specific complex and/or rising-risk member populations, identifies members appropriate for population health programs using data informatics, and provides interventions and education to promote health prevention and promotion. The role develops, reviews, and evaluates operating policies and procedures; analyzes operations and services against program goals using databases, dashboards, performance outcome data, and reports; and recommends changes based on findings. It collaborates with internal teams to identify gaps and workflow improvements for special populations, serves as a subject matter expert on special populations and related requirements and programs, provides staff education and training, and oversees resources used by specialty populations, including coordination of secure transportation requests.
Requirements
- Bachelor’s degree in Nursing and one year of experience providing care to individuals with complex physical, chronic, and/or behavioral health conditions; or a master’s degree in a Health or Human Services field and one year of such experience.
- Fully licensed by the state of North Carolina as an LCSW, LCMHC, LPA, LMFT, LCAS, or RN.
- Valid driver’s license.
- Must reside within North Carolina.
- Must be able to travel within the catchment area as required.
Nice To Haves
- At least one year of experience in clinical policy review, conducting audits, or quality improvement review.
Responsibilities
- Develop, review, and evaluate operating policies, practices, and procedures with department-wide impact, and provide critical feedback on outcomes to improve effectiveness.
- Manage, review, and analyze operations and services for adherence to program goals and objectives using databases, dashboards, performance outcome data, and reports; recommend changes based on analyses.
- Collaborate with internal teams to identify gaps and 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 populations, such as coordination of secure transportation requests.
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.
- Flexible work schedules for some roles with management approval.
- Health insurance with no premium for employee coverage.
- Flexible Spending Accounts.
- 24 days of paid time off plus 12 paid holidays in the first year.
- NC Local Government Retirement Pension (defined-benefit plan).
- 401(k) with 5% employer match and immediate vesting.
- Public Service Loan Forgiveness (PSLF) qualifying employer.
- Quarterly stipend for remote work supplies.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
