Quality Management Specialist III – Population Health
Posted 1ds ago
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Job Description
Quality Management Specialist developing policies and analyzing care data for Trillium Health Resources, a North Carolina behavioral-health managed-care organization. Supporting population health programs for complex member populations.
Responsibilities:
- Develop, review and evaluate operating policies, practices and procedures with department-wide impact
- Provide critical feedback on outcomes to enhance effectiveness
- Manage, review, and analyze operations and services for adherence to program goals and objectives
- Utilize databases, dashboards, performance outcome data and reports
- Recommend changes based on analyses
- Collaborate with internal teams to identify gaps or opportunities for improved workflows or process changes for special populations
- Serve as a subject matter expert regarding identified special populations, regulatory requirements, policies, procedures, programs and staff support
- Provide staff education and training on relevant program components
- Oversee utilization of resources used by specialty populations, including coordination of secure transportation requests
- Identify members appropriate for population health programs using data informatics
- Provide interventions and education to promote health prevention and promotion
Requirements:
- Bachelor's degree in Nursing and one (1) year of experience providing care to individuals with complex physical, chronic, and/or behavioral health conditions; OR Master's degree in a Health or Human Services field and one (1) year of experience providing care to individuals with complex physical, chronic, and/or behavioral health conditions
- Fully licensed by the state of North Carolina as an LCSW, LCMHC, LPA, LMFT, LCAS or RN
- Must have a valid driver’s license
- Must reside within North Carolina
- Must be able to travel within catchment as required
- Preferred: At least one (1) year of clinical policy review, conducting audits, or quality improvement review experience
- All candidates must pass a drug test as a condition of employment
Benefits:
- A collaborative, mission-driven work environment
- Competitive benefits
- Work-from-home options for most positions
- Opportunities for professional growth in a diverse inclusive culture
- Flexible work schedules with some roles 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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