Provider Network Specialist II – Adult Behavioral Health
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Job Description
Provider network specialist coordinating onboarding, compliance, and quality monitoring for Trillium Health Resources' adult behavioral-health network in North Carolina.
Responsibilities:
- Support development and ongoing coordination of the provider network
- Engage providers and coordinate onboarding activities
- Monitor provider performance to support network readiness, compliance, and access to services
- Provide service-specific support and quality monitoring for enhanced services serving adults with SPMI
- Apply NC Person-Centered Planning guidance, Clinical Coverage Policy/service definition, and record management standards
- Engage providers in onboarding, readiness, and implementation activities
- Coordinate provider implementation plans and track progress
- Facilitate provider meetings and communication activities
- Support resolution of provider performance issues and gaps
- Collect, analyze, and report data in a timely and accurate manner
- Cultivate collaborative relationships with network providers through technical support and communication outreach
- Evaluate monitoring findings and identify compliance issues
- Coordinate corrective action plans and monitor implementation
- Communicate monitoring results and requirements to providers
- Provide guidance supporting compliance and quality outcomes
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; OR Associate's degree in a related field and four (4) years of relevant experience; OR Bachelor's degree in a related field and two (2) years of relevant experience; OR equivalent combination of education and experience
- Must have a valid driver's license
- Must reside within Trillium's Catchment of North Carolina
- Must be able to travel within catchment as required
- Preferred: 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 developing Person-Centered Plans (PCPs) and understanding NC DHHS Person-Centered Planning guidance
- Preferred strong data-driven approach with ability to analyze trends and present findings
- Preferred proficiency with Excel and other tools used for data tracking, analysis, and reporting
- All candidates must pass a drug test as a condition of employment
Benefits:
- A collaborative, mission-driven work environment
- Competitive benefits and work-from-home options for most positions
- Opportunities for professional growth in a diverse inclusive culture
- Flexible work schedules available for some positions with management approval
- Work-from-home options available for most positions
- 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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