Quality Management Specialist II – IDD

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

📋 Description

• Oversee the services provided to members utilizing Home and Community Based Services (HCBS) including Residential, Day Support, and Supported Employment throughout the member's plan year.

• Ensure adherence to monitoring requirements for Innovations Waiver services.

• Guarantee compliance with the final HCBS rule.

• Evaluate and oversee services in collaboration with the Care Management team.

• Ensure services meet state standards, waiver requirements, and Medicaid regulations.

• Review service documentation and claims for accuracy.

• Foster member satisfaction with services through continuous communication and prompt follow-up on issues and concerns.

• Conduct both announced and unannounced monitoring visits to members, including evenings and weekends as necessary.

• Monitor services via direct observation, telephone, email, and other methods across all settings.

• Travel within the designated catchment area as needed.

⛳️ Requirements

• Must achieve Qualified Professional (QP) status in accordance with NC regulations through one of the specified qualification pathways.

• Fully licensed by the NC governing board that oversees human services professions; OR possess a fully licensed RN designation in North Carolina with four years of full-time experience with the MH/DD/SA population.

• Hold a Master’s degree in a human service field accompanied by one year of full-time experience in MH/DD/SA, or qualifying supervised substance abuse counseling experience.

• Possess a Bachelor’s degree in a human service field with two years of full-time experience in MH/DD/SA, or qualifying supervised substance abuse counseling experience.

• Hold a Bachelor’s degree in a different field with four years of full-time experience in MH/DD/SA, or qualifying supervised substance abuse counseling experience.

• If serving members with LTSS needs, possess at least two years of previous experience in LTSS and/or HCBS coordination, care delivery monitoring, and care management.

• A valid driver’s license is required.

• Must be a resident of North Carolina and live within 75 miles of Trillium's Southern Region.

• Southern Region counties include: Bladen, Brunswick, Columbus, Hoke, Lee, Moore, New Hanover, Robeson, and Scotland.

• Must be willing to travel within the catchment area as needed.

• Must have legal authorization to work in the United States without the need for employment sponsorship now or in the future.

• Preferred professional experience working with individuals with IDD or TBI Innovations populations.

• Experience with IDD Services, monitoring service implementation, and addressing health and safety needs is preferred.

• All candidates are required to pass a drug test as a condition of employment.

🏝️ Benefits

• A collaborative and mission-focused work environment.

• Competitive benefits package and work-from-home options available for most positions.

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

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

• Health Insurance with no premium costs for employee coverage.

• Flexible Spending Accounts offered.

• Accrual of 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year.

• Participation in the NC Local Government Retirement Pension (defined-benefit plan).

• 401k plan with a 5% employer match and immediate vesting.

• Employer qualifies for Public Service Loan Forgiveness (PSLF).

• Quarterly stipend provided for remote work supplies.