Trillium Health Resources

Clinician

• Provide clinical review of services for members or enrollees with mental health, substance use, and/or developmental disabilities including diagnosis review, medical necessity criteria, determining member eligibility; level of care needed and making service authorization decisions regarding individual service authorizations with timely, clear, concise documentation.
• Provide clinical triage for members seeking services through Screening, Triage and Referral.
• Provide consultation and technical assistance to providers regarding clinical care needs, levels of care, Client Rights Rules, evidenced based practices, scope of practice issues etc.
• Provide ongoing review/staffing/consultation of treatment documentation of needs for members participating in group, family or individual services.

MH/SU UM Clinician

General

• Oversee and maintain project plans, project timelines, milestones, stakeholder communications management, and other day to day project activities.
• Has autonomous decision-making authority on projects that impact the agency.
• Lead assigned project(s) with team(s) both internal and external through initial development until project completion and released from Network Development for ongoing monitoring in other departments across the organization.
• Provide project status updates/reports using dashboards and/or Smartsheet at regular intervals during all projects.
• Ensure all assigned project components are completed in a timely manner.
• Address network needs via specific provider recruitment and the publication of Open Enrollments, Requests for Proposals (RFP), Request for Application (RFA) or Request for Information (RFI).
• Independently complete Requests for Proposals, Application and/or Information using knowledge by Subject Matter Expert’s (SME) to obtain the service specific to the needs of the population, area and organization.

Network Development Coordinator

Pharmacist

• Provide daily support to the Trillium pharmacy team
• Coordinate work with the Pharmacy Benefit Manager (PBM) and the State Department of Health Benefits (DHB)
• Assist in performing medication reconciliations under supervision
• Support pharmacy team in clinical programs including Medication Reconciliations
• Responsible for data analysis and reports
• Assist Trillium team members with pharmacy related information/projects
• Assist with pharmacy provider network outreach and communication
• Handle member inquiries related to formulary/preferred drug list (PDL) process or access issues

Pharmacy Technician

• 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.

Network Auditing Coordinator

Data Analyst

• Provide user account life cycle management, including creating, provisioning, securing, and inactivation of access.
• Participate in projects and support operations focused on implementing Identity and Access Management (IAM) integrations and Roles Based Access Control (RBAC) strategies and integrations.
• Collaborate in the design, implementation, and support of the IAM technologies.
• Participate in projects to ensure standard processes and procedures are implemented when rolling out new provisioning and role management points.
• Develop system access and security implementation plans derived from operational customer needs and requests.

Senior Data Analyst, Identity and Access Management

Business Operations

• Drive development and delivery using Agile Scrum methodology.
• Participate in and facilitate (when needed) daily scrum, sprint planning, sprint demo and retrospective meetings.
• Evaluate and report on the technical performance of assigned team members.
• Discover and contribute to the development, implementation, and maintenance of business systems functional architecture, detail systems design, configuration, or program specifications to deliver IT system outcomes that meet user and organization needs.

Agile Product Manager – Business Systems

Software Engineer

• Design and optimize relational database structures.
• Write complex SQL queries, stored procedures, and triggers.
• Perform query optimization and database tuning.
• Integrate SQL databases with applications and reporting tools.
• Enhance/support existing business applications.

SQL Developer

General Counsel

• Advise and assist staff with respect to reconsideration reviews, appeals, complaints, grievances, incidents, and inquiries/investigations/audits conducted by regulatory authorities
• Develop and review contracts and agreements with state agencies, counties, providers, vendors, stakeholders or other entities and individuals
• Supervise the appeals unit, which facilitates all in-house reviews of appeals of agency decisions, including actions on authorization requests, actions with providers, and claims denial appeals
• Prepare employees for depositions and court appearances, respond to subpoenas directed to the organization and/or employees, and coordinate with judicial and legal authorities
• Oversee requests for documents under the NC Public Records law and assist as needed with responses to external requests for information from governmental or non-governmental organizations
• Oversee the management and monitoring of Trillium’s subcontracting of Tailored Plan core services to ensure adherence to Trillium’s Tailored Plan contract and related NC DHHS guidelines, laws, rules and regulations

General Counsel – Chief Compliance Officer

• Assist the Clinical Pharmacy Director in providing clinical oversight for the development and implementation of the pharmacy program plan for clinical services
• Evaluate medication reconciliations and provide Medication Management referrals, education, and outreach to Care Management, providers, and members
• Assist pharmacy team members with pharmacy related information/projects
• Support/perform educational activities for Trillium colleagues, providers, and members when necessary
• Assist in the development and maintenance of cost-effective pharmacy programs, including management of the formulary; utilization management programs; and responding to internal questions

Clinical Pharmacist

Director

• Serve as the primary leader and public face of the NC ROOTS Hub across any regions awarded to Trillium.
• Oversee implementation of required initiatives, including perinatal health (including CHW/Doula coordination models), chronic disease prevention and management, and Food is Medicine programs.
• Design and operationalize a sub-awardee model for hospitals, providers, and CBOs.
• Oversee multi-million-dollar regional budgets and funding allocations.
• Build trust across diverse stakeholders, including historically underserved communities.
• Build and lead a high-performing regional team, including operations, Community engagement, program implementation, and data and analytics.

Lead Executive Director

Care Coordinator

• Responsible for providing care coordination (treatment planning, assessment, monitoring, educating, and referral/linking) to individuals identified in the Transitions to Community Living Initiative Special Needs Populations (TCLI)
• Work collaboratively with licensed Clinicians, Registered Nurses, and Peer Support Specialists to ensure successful discharge/transition planning/post transition monitoring
• Provide care coordination/care management to assigned TCL individuals who may have identified needs with behavioral health, physical health, co-occurring, co-morbid, or multi-morbid conditions
• Assess member’s needs who have transitioned into supportive housing to determine if additional support and services are needed for continued independent living
• Ensure timely and accurate documentation of all planning and coordination efforts in multiple software platforms and State database systems

Transition Care Coordinator

IT Support

• Develop the service strategy for one or more services in the IT organization
• Review business requests for service enhancements and undertake cost evaluation, standards reviews, and prioritization
• Contribute service descriptions and service-level agreements (SLAs) for specific services to the organization’s service catalog
• Interact with technology brokers/vendor managers to identify and evaluate new technology products for their services
• Set up, manage, and evaluate end to end Service Desk processes and workflows

IT Service Desk Manager

• Assist members in locating appropriate housing based on program requirements, their preferences and availability.
• Educate landlords/property managers/owners on TCL and the TCL Voucher subsidy.
• Provide technical assistance to landlords regarding specific members.
• Work collaboratively with members and guardians to assess members’ financial needs and assist members in developing a budget that will allow them to successfully live independently.
• Coordinate directly with members, landlords, tenancy providers, internal TCL, Care Management, and Finance staff, and other supports to identify and address housing issues and barriers, as well as any other social determinants of health, as a means to maintain permanent supportive housing, avoid formal evictions, and procure alternative housing through TCL if warranted.

Housing Development Coordinator

Financial Planning and Analysis

• Support the development of the regional hub budget, the strategy, and performance management program.
• Analyze financial data and create financial models for forecasting, trending, and results analysis to support scenario planning, budget development, and decision-making processes.
• Monitor funds to ensure distribution according to contract terms; milestones and deliverables; and performance-based payment structures.
• Monitor sub-awardee spending to ensure compliance with related regulations, standards, and policies.
• Prepare and deliver accurate, timely financial reports for leadership.
• Review and analyze financial information to identify trends, risks, and alignment with performance metrics.

Senior Budget Analyst

• Develop, maintain, and advance collections of related projects with a variety of stakeholders across the enterprise to effectively deliver organization capabilities supporting strategic and operational demands.
• Accountable for the oversight and governance of a wide variety of IT projects and programs, varying in size and scope from large-scale transformational projects to a program portfolio of related initiatives, ensuring they meet business outcomes.
• Demonstrate a deep understanding of business acumen and organizational knowledge between administrative, clinical, human resource, information technology, and quality functions including the interaction and interdependencies of each business unit.
• Develop, maintain, and execute large-scale comprehensive projects or integrated program plans, including charters, scope definition, communication plans, roadmaps, resource allocation, timelines, milestones, deliverables, risk registers, and dependency management across the portfolio.
• Lead and supervise a team of Project Managers and Project Analysts, providing talent development, coaching, performance evaluations, and overseeing the requisition process from candidate review and selection to new staff onboarding.