[Hiring] Network Auditing Coordinator @TRILLIUM HEALTH RESOURCES

Role Description

Trillium Health Resources has a career opening for a Network Auditing Coordinator to join our team! The Network Auditing Coordinator will support the development and management of the Provider Network for members who have been identified as having Mental Health, Developmental Disabilities or Substance Use needs and will be responsible for overseeing the monitoring activities of the provider network. This position will be responsible for maintaining knowledge of applicable Federal, State, and Accreditation requirements and ensuring that the organization maintains compliance with these requirements.

On a typical day, you might:

• Maintain network quality by performing provider monitoring to ensure compliance with rules, regulations and service definition requirements.
• Facilitate the resolution of deficiencies through the issuance, review and acceptance of Plans of Corrections (POC) and monitoring implementation of these plans.
• Establish a partnership and collaboration with Trillium Health Resources Network providers by providing technical assistance/guidance, facilitating communication, and possible inclusion in various committees as necessary.
• Conduct quality audits in an objective, systematic, unbiased manner. Ensure that quality health care determinations are being made based on the provider’s contract/policies and procedures/accreditation standards, as well as federal and state laws/mandates.
• Implement and maintain Inter-rater Reliability when conducting reviews.

Qualifications

• Must meet Qualified Professional (QP) status.
• Fully licensed by the NC governing board regulating Human Services professions; OR Fully licensed RN who is licensed to practice in the state of NC by the NC Board of Nursing who also has four (4) years of full-time experience with the MH/DD/SA population served; OR
• A graduate of a college or university with a Master’s degree in a human service field and has one year of full-time, pre or post-graduate degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has one year of full-time, pre or postgraduate degree accumulated supervised experience in alcoholism and drug abuse counseling; OR
• A graduate of a college or university with a bachelor's degree in a human service field and has two years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has two years of full-time, pre or post bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling; OR
• A graduate of a college or university with a bachelor's degree in a field other than human services and has four years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has four years of full-time, pre or post-bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling.
• Must have a valid driver’s license.
• Must reside within 75 miles of Trillium’s South Central Region, which includes the following counties: Carteret, Craven, Duplin, Jones, Lenoir, Onslow, Pender, Sampson, and Wayne.
• Must be able to travel within catchment as required.

Requirements

• Human Services degree preferred.
• Licensure/certification may be accepted as noted above.

Benefits

• Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles 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.

How to Apply

To be considered, submit your application and resume through our ADP Career Center. Your resume must include:

• Employer name, dates of service (month/year), average hours worked per week, and essential job duties.
• Education details (degree type, date awarded, institution, field of study).
• Licensure/certification information, if applicable.

After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You’ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.

Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.

Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.