Quality Management Specialist II – IDD

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

📋 Description

• Oversee Home and Community Based Services (HCBS) for Residential, Day Support, and Supported Employment during members’ plan years.

• Ensure adherence to the final HCBS rule.

• Evaluate services for compliance with state standards, waiver stipulations, and Medicaid regulations.

• Assess service documentation and claims.

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

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

• Evaluate services through direct observation, phone contact, emails, and other methods across all environments.

• Collaborate proactively with the Care Management team to ensure quality support and compliance with waiver requirements.

• Travel within the catchment area as needed.

⛳️ Requirements

• Must fulfill Qualified Professional (QP) status as per NC requirements via one of the designated licensure, RN, master’s degree, or bachelor’s degree and experience pathways.

• Fully licensed by the NC governing board that oversees human services professions; or fully licensed RN authorized to practice in North Carolina with four years of full-time MH/DD/SA experience; or qualifying master’s/bachelor’s degree along with specified MH/DD/SA or substance-abuse counseling experience.

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

• Must hold a valid driver’s license.

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

• Must be capable of traveling within the catchment area as required.

• Professional experience focused on individuals with Intellectual Developmental Disabilities (IDD) or Traumatic Brain Injury (TBI) Innovations populations is preferred.

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

🏝️ Benefits

• Collaborative, mission-driven work atmosphere.

• Competitive benefits package.

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

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

• Health Insurance with no premium cost for employee coverage.

• Flexible Spending Accounts.

• 24 days of Paid Time Off (PTO) along with 12 paid holidays in your initial year.

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

• 401k with 5% employer matching and immediate vesting.

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

• Quarterly stipend for remote work supplies.