Quality Management Specialist II – IDD

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

📋 Description

• Oversee services for members utilizing HCBS Residential, Day Support, and Supported Employment throughout the member's plan year.

• Ensure adherence to monitoring standards for Innovations Waiver services.

• Guarantee compliance with the final HCBS rule.

• Evaluate and oversee services while collaborating with the Care Management team to ensure high-quality support and compliance with waiver requirements.

• Verify services comply with state standards, waiver conditions, and Medicaid regulations.

• Analyze service documentation and claims.

• Foster service satisfaction through consistent communication and prompt follow-up on concerns and issues.

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

• Assess services through direct observation, phone calls, emails, and various other methods across all settings.

⛳️ Requirements

• Must achieve Qualified Professional (QP) status in accordance with NC requirements through one of the stipulated qualifying pathways.

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

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

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

• Hold a Bachelor's degree in another discipline and have four years of full-time experience in MH/DD/SA, or possess qualifying supervised substance-abuse counseling experience.

• If working with members requiring LTSS, a minimum of two years of prior experience in LTSS and/or HCBS coordination, care delivery monitoring, and care management is required.

• A valid driver's license is necessary.

• Must reside within Trillium's North Central Region, which includes Beaufort, Dare, Edgecombe, Greene, Hyde, Nash, Pamlico, Pitt, Tyrrell, Washington, or Wilson counties.

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

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

• All applicants must successfully pass a drug test as a precondition for employment.

🏝️ Benefits

• A collaborative, mission-focused working environment.

• Competitive benefits package.

• Work-from-home options available for most roles.

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

• Flexible work schedules may be available for specific positions upon management approval.

• Health Insurance at no cost for employee coverage.

• Flexible Spending Accounts.

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

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

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

• Qualifying employer for Public Service Loan Forgiveness (PSLF).

• Quarterly stipend for remote work supplies.