Provider Network Specialist III
Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/developmental (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.
About the role
The Provider Network Specialist III supports provider network operations and contributes to the execution of network strategies that strengthen clinical performance. The role collaborates with cross-functional teams to evaluate provider needs, analyze clinical and operational data, and ensure network adequacy, compliance, and effective service delivery. This position plays a key role in guiding providers on quality, performance standards, and improvement opportunities to enhance care outcomes and support organizational goals.
Responsibilities
- Apply clinical expertise to support provider network operations and collaborate with colleagues to promote high-quality, person-centered care within the provider network.
- Contribute clinical insight to network development and management activities that strengthen provider performance and support value-based care models.
- Assist in addressing provider performance issues, access barriers, and network gaps by conducting clinical reviews, performing outreach, and supporting coordinated problem resolution.
- Partner with cross-functional teams to align clinical considerations with operational, regulatory, and organizational requirements.
- Participate in continuous improvement activities related to provider performance, clinical outcomes, network quality, and member access.
Benefits
- Competitive benefits package
- Work-from-home options for most positions
- Opportunities for professional growth in a diverse, inclusive culture
Pay
$68,890 - $92,138
Office Location: Remote within North Carolina