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Quality Assurance Clinician

extra holidays - fully flexible
Remote: 
Full Remote
Contract: 
Salary: 
63 - 78K yearly
Experience: 
Mid-level (2-5 years)
Work from: 
North Carolina (USA), United States

Offer summary

Qualifications:

Master’s degree or Bachelor’s with full licensure acceptable., At least one year of post-degree experience in MH/SU/IDD services., Preferred two years post-Master’s experience in clinical setting., Active valid licensure in NC (LCSW, LCMHC, LCAS, LPA, LMFT)., Must have a valid driver’s license..

Key responsabilities:

  • Monitor and ensure compliance with quality care standards.
  • Review medical records and assess quality of care.
  • Provide clinical oversight for NCQA file reviews.
  • Collaborate across departments and provide consultation.
  • Participate in appeals and conduct peer reviews.
Trillium Health Resources logo
Trillium Health Resources Insurance SME https://www.trilliumhealthresources.org/
501 - 1000 Employees
See more Trillium Health Resources offers

Job description

Pay Plan Title: Clinician

Working Title: Quality Assurance (QA) Clinician

FLSA Status: Exempt

Posting Salary Range: $62,712 - $77,564

Office Location: Remote in North Carolina        

POSTING DETAILS:

Make an Impact  

Trillium Health Resources is a local governmental agency (LME/MCO) in North Carolina that manages serious mental health, substance use, and intellectual/developmental disability services. Serving in 46 counties, we help individuals and their families strengthen well-being and build foundations for a healthy life.

Join our team as we empower others to live their best lives by providing access to quality healthcare. We offer a challenging, engaging work environment where staff take home more than a paycheck. Every day, we see the results of our dedication – in the smiles of children on our accessible playgrounds and in the pride on the face of an adult cooking a meal for the first time. Working at Trillium Health Resources is more than just a job; it is an opportunity to make a direct impact on the communities we serve.

At Trillium, we know that empowering others begins with supporting and developing our team. That’s why we offer competitive benefits and work-from-home flexibility so that our employees thrive outside of the office. We’re also committed to building a diverse, inclusive culture where all employees have the potential to grow professionally and personally.

What We’re Looking For:

We are seeking a licensed clinician who will be part of the quality management team, someone who wants to ensure the highest standards of care. The Quality Assurance (QA) Clinician will monitor, review, and assist in maintaining compliance with standards and best practices. This role will also review medical records and report to assess quality of care, as well as assisting in quality assurance and improvement activities. 

On a typical day, you might:

  • Provide clinical oversight and monitoring of NCQA file reviews. 
  • Make sound judgments based on clinical and legal requirements
  • Conduct inter-rater reliability. 
  • Provide consultation and technical assistance on evidenced based practice, scope of practice issues. 
  • Collaborate cross departmentally. 
  • Conduct post-payment reviews. 
  • Participate in appeals and hearing processes. 
  • Conduct peer clinical reviews.

Employee Benefits:

Trillium knows that work/life balance is important. That’s why we offer our employees competitive benefits and flexibility that is second to none. Take a look at what we have to offer:

  • Typical working hours are 8:30am-5pm
  • A remote work option available for most positions
  • Health Insurance - no premium for employee coverage
  • Flexible Spending Accounts
  • Paid Time Off (PTO) of 24 days, plus 12 paid holidays within first year of employment
  • NC Local Government retirement pension. This is a defined-benefit retirement plan that will pay you a monthly amount upon retirement, for the rest of your life, with as little as five years of service. For more information, go to: https://files.nc.gov/retire/documents/files/Actives/LGERSHandbook.pdf
  • 401k with 5% employer match & immediate vesting
  • Public Service Loan Forgiveness Qualifying Employer

Qualifications: 

Education: Master’s

Bachelor’s with full licensure is acceptable

Experience: At least one (1) year of post-degree progressive experience providing similar services to the MH/SU/IDD population.

Preferred experience: Prefer a minimum of two (2) years post- Master’s experience in a clinical setting with the MH/SU/IDD population.

License/Certification: Active valid licensure in profession (social work, counseling, or psychology) is required. Active valid license in the state of North Carolina as a LCSW, LCMHC, LCAS, LPA, LMFT.

Must have a valid driver’s license

Must reside in NC to be considered for remote status

Deadline for application: 12/04/2024 at 11:59 pm

To be considered for employment, all candidates are required to submit an application through ADP and upload a current resume.  Your resume must provide your level of education and detailed work experience, including: 

  • Employer Name
    1. Dates of service (month & year)
    2. Average number of hours worked per week
    3. Essential duties of the job as related to the position you’re applying for
  • Education
    1. Degree type
    2. Date degree was awarded
    3. Institution
  • Licensure/certification, if applicable

After submitting your application through our career center in ADP, your resume will be reviewed to ensure that your skills and experience meet the essential criteria for the role you have applied for.

Join our Talent Community through our ADP career center to stay informed about positions you may qualify for. Remember to keep an update resume in the Talent Community profile. 

The diversity of the communities we serve is reflected in our employees. Trillium Health Resources is an Equal Employment Opportunity (EEO) employer.

Trillium Health Resources is a drug-free workplace. Candidates are required to pass a drug test as a condition of employment.

#Innovation #Technology  #Careers  #NorthCarolina  #BehavioralHealth

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Experience

Level of experience: Mid-level (2-5 years)
Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Problem Solving
  • Collaboration
  • Analytical Thinking
  • Quality Assurance
  • Verbal Communication Skills

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