Quality Management Specialist II – IDD

Trillium Health Resources

. Ensure services for members receiving Home and Community Based Services (HCBS) of Residential, Day Support, and Supported Employment are monitored during the member's plan year .

Posted 10/27/2026full-timeRemote • North Carolina • United StatesJuniorMid-Level💰 $56,270 - $69,898 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in monitoring Home and Community Based Services (HCBS) compliance, conducting assessments, and ensuring member satisfaction through effective communication. Holds relevant qualifications and experience in managing services for individuals with IDD or TBI populations.

Highest-signal resume keywords

Qualified Professional (QP) StatusLicensed RN In North CarolinaMaster's Degree In Human ServicesExperience With IDD ServicesLTSS And HCBS Coordination Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Monitoring Service ImplementationService Documentation ReviewCompliance With Medicaid RegulationsCare Management CoordinationSubstance Abuse Counseling Experience

Soft Skills

Effective CommunicationProblem-SolvingTimely Follow-Up

Certifications & Qualifications

Licensed By NC Governing Board

Industry Keywords

Home And Community Based Services (HCBS)Innovations Waiver ServicesMental Health/Developmental Disabilities/Substance Abuse (MH/DD/SA)Long-Term Services And Supports (LTSS)Direct Observation Monitoring

About the role

Key responsibilities & impact

Ensure services for members receiving Home and Community Based Services (HCBS) of Residential, Day Support, and Supported Employment are monitored during the member's plan year
Ensure monitoring requirements for Innovations Waiver services are followed
Ensure compliance with the final HCBS rule
Assess and monitor services in coordination with the Care Management team
Monitor services for compliance with state standards, waiver requirements, and Medicaid regulations
Review service documentation and claims
Promote satisfaction with services through ongoing communication and timely follow-up on concerns and issues
Conduct announced and unannounced monitoring visits to members, including nights and weekends as needed
Monitor services through direct observation, telephone contact, email, and other methods in all settings
Travel within the catchment area as required

Requirements

What you’ll need

Must meet Qualified Professional (QP) status per NC requirements through one of the listed qualification pathways
Fully licensed by the NC governing board regulating human services professions; OR fully licensed RN licensed to practice in North Carolina with four years of full-time MH/DD/SA population experience
Master's degree in a human service field with one year of full-time MH/DD/SA experience, or qualifying supervised substance abuse counseling experience
Bachelor's degree in a human service field with two years of full-time MH/DD/SA experience, or qualifying supervised substance abuse counseling experience
Bachelor's degree in another field with four years of full-time MH/DD/SA experience, or qualifying supervised substance abuse counseling experience
If serving members with LTSS needs, at least two years of prior LTSS and/or HCBS coordination, care delivery monitoring, and care management experience
Must have a valid driver's license
Must reside in North Carolina and within 75 miles of Trillium's Southern Region
Southern Region counties: Bladen, Brunswick, Columbus, Hoke, Lee, Moore, New Hanover, Robeson, and Scotland
Must be able to travel within catchment as required
Must be legally authorized to work in the United States without requiring employment sponsorship now or in the future
Professional experience focused on individuals with IDD or TBI Innovations populations preferred
Experience with IDD Services, monitoring service implementation, and health and safety needs preferred
All candidates must pass a drug test as a condition of employment

Benefits

Comp & perks

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