Quality Management Specialist II – IDD

Trillium Health Resources

. Monitor Home and Community Based Services (HCBS) Residential, Day Support, and Supported Employment services during members’ plan years .

Posted 11/11/2026full-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) for compliance with state standards and Medicaid regulations, while ensuring member satisfaction through effective communication and proactive care management. Holds Qualified Professional (QP) status and possesses relevant experience in supporting individuals with Intellectual Developmental Disabilities (IDD) or Traumatic Brain Injury (TBI).

Highest-signal resume keywords

Qualified Professional (QP) StatusHCBS Coordination ExperienceMedicaid Regulations ComplianceIntellectual Developmental Disabilities (IDD) ExpertiseValid Driver's License

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Compliance MonitoringService Documentation ReviewClaims ReviewCare ManagementLTSS CoordinationSubstance-Abuse Counseling ExperienceDirect ObservationTelephonic ContactMember Satisfaction PromotionTravel Coordination

Soft Skills

Effective CommunicationProactive Problem SolvingTimely Follow-UpTeam CollaborationMember Advocacy

Certifications & Qualifications

Licensed RN in North CarolinaHuman Services Professional License

Industry Keywords

Home and Community Based Services (HCBS)MedicaidState StandardsWaiver RequirementsIntellectual Developmental Disabilities (IDD)Traumatic Brain Injury (TBI)Mental Health/Developmental Disabilities/Substance Abuse (MH/DD/SA)Catchment Area TravelMonitoring VisitsDrug Test Compliance

About the role

Key responsibilities & impact

Monitor Home and Community Based Services (HCBS) Residential, Day Support, and Supported Employment services during members’ plan years
Ensure compliance with the final HCBS rule
Monitor services for compliance with state standards, waiver requirements, and Medicaid regulations
Review service documentation and claims
Promote member satisfaction through ongoing communication and timely follow-up on concerns and issues
Make announced and unannounced monitoring visits to members, including nights and weekends as needed
Monitor services through direct observation, telephonic contact, emails, and other methods in all settings
Work proactively with the Care Management team to ensure quality support and adherence to waiver requirements
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 licensure, RN, master’s degree, or bachelor’s degree and experience 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 experience; or qualifying master’s/bachelor’s degree and specified MH/DD/SA or substance-abuse counseling experience
If serving members with LTSS needs, must additionally have 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 within Trillium’s North Central Region: Beaufort, Dare, Edgecombe, Greene, Hyde, Nash, Pamlico, Pitt, Tyrrell, Washington, or Wilson counties
Must be able to travel within catchment as required
Professional experience focused on individuals with Intellectual Developmental Disabilities (IDD) or Traumatic Brain Injury (TBI) Innovations populations preferred
All candidates must pass a drug test as a condition of employment

Benefits

Comp & perks

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