Care Management Consultant
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Job Description
Tailored Care Management Consultant monitoring provider compliance and performance for North Carolina’s behavioral health MCO. Providing technical assistance, corrective actions, and quality improvement strategies.
Responsibilities:
- Support the quality, compliance, and performance of the Tailored Care Management provider network
- Provide technical assistance, monitoring, and performance oversight to support provider compliance and continuous improvement in care management service delivery
- Monitor provider compliance with Tailored Care Management requirements and standards
- Provide technical assistance and guidance to provider organizations
- Support development and implementation of corrective action plans
- Conduct reviews to assess compliance with regulatory, contractual, and accreditation requirements
- Collaborate with internal stakeholders to support network performance and quality outcomes
- Analyze performance data and recommend improvement strategies
Requirements:
- High school diploma or GED and six (6) years of experience with medical practices, clinical settings, managed care organizations, provider relations, network development, or provider contracting, including experience leading project plans and overseeing deliverables; OR
- Associate's degree in population health, healthcare administration, business administration, health, psychology, sociology, social work, nursing, or another relevant human service area and four (4) years of experience with medical practices, clinical settings, managed care organizations, provider relations, network development, or provider contracting, including experience leading project plans and overseeing deliverables; OR
- Bachelor's degree in population health, healthcare administration, business administration, health, psychology, sociology, social work, nursing, or another relevant human service area and two (2) years of experience with medical practices, clinical settings, managed care organizations, provider relations, network development, or provider contracting, including experience leading project plans and overseeing deliverables; OR
- Equivalent combination of education and experience.
- Must have a valid driver's license
- Must reside within Trillium's catchment area in North Carolina, comprising the listed counties
- Must be able to travel within catchment as required
- All candidates must pass a drug test as a condition of employment
- Master's degree in a related field preferred
Benefits:
- A collaborative, mission-driven work environment
- Competitive benefits
- Work-from-home options for most positions
- Flexible work schedules available for some 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 5% employer match and immediate vesting
- Public Service Loan Forgiveness (PSLF) qualifying employer
- Quarterly stipend for remote work supplies
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