Provider Network Specialist II – Adult Behavioral Health

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Assist in the development and ongoing management of the provider network.

• Engage with providers and coordinate their onboarding processes.

• Monitor provider performance to ensure network readiness, compliance, and access to services.

• Deliver service-specific support and quality monitoring for enhanced services catering to adults with SPMI.

• Implement NC Person-Centered Planning guidelines, Clinical Coverage Policies/service definitions, and record management standards.

• Involve providers in onboarding, readiness, and implementation tasks.

• Organize provider implementation plans and monitor their progress.

• Facilitate provider meetings and communication efforts.

• Assist in resolving provider performance issues and identifying gaps.

• Collect, analyze, and report data promptly and accurately.

• Foster collaborative relationships with network providers through technical support and outreach communications.

• Assess monitoring outcomes and identify compliance challenges.

• Develop corrective action plans and oversee their implementation.

• Communicate monitoring results and requirements to providers effectively.

• Offer guidance to support compliance and achieve quality outcomes.

⛳️ Requirements

• High school diploma or GED with six (6) years of experience in medical practices, clinical environments, managed care organizations, provider relations, network development, or provider contracting; OR an Associate's degree in a related field with four (4) years of relevant experience; OR a Bachelor's degree in a related field with two (2) years of relevant experience; OR an equivalent combination of education and experience.

• Possession of a valid driver's license is required.

• Must reside within Trillium's Catchment area in North Carolina.

• Ability to travel within the catchment area as necessary.

• Preferred: At least one (1) year of work experience in mental health, substance use, or developmental disabilities.

• Preferred experience with Assertive Community Treatment (ACT), Community Support Team (CST), and/or Transition Management Services (TMS).

• Preferred experience in developing Person-Centered Plans (PCPs) and a strong understanding of NC DHHS Person-Centered Planning guidelines.

• Preferred a strong data-driven approach with the ability to analyze trends and present findings effectively.

• Preferred proficiency in Excel and other tools utilized for data tracking, analysis, and reporting.

• All candidates must successfully pass a drug test as a condition of employment.

🏝️ Benefits

• A collaborative and mission-driven work environment.

• Competitive benefits and remote work options for most roles.

• Opportunities for professional development within a diverse and inclusive culture.

• Flexible work schedules available for certain positions with management approval.

• 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 a 5% employer match and immediate vesting.

• A qualifying employer for Public Service Loan Forgiveness (PSLF).

• Quarterly stipend for remote work supplies.