Jobs at Trillium Health Resources

Designs, develops, and maintains full-stack applications, APIs, integrations, and data-processing components. Analyzes EDI data flows, ensures transaction accuracy, troubleshoots integration issues, participates in system architecture, and writes unit and integration tests. The role also documents EDI processes, resolves complex application issues, and supports reliable, scalable application performance while collaborating with IT teams.

Leads claims, analysis, and enrollment operations for a managed care organization. Oversees claims adjudication, reconciliation, auditing, reporting, reimbursement procedures, data analysis, compliance, and team performance. Manages staff development and accountability while coordinating cross-functional efforts to improve claims accuracy, payment integrity, and operational efficiency. The role is remote within North Carolina and requires travel within the organization’s service area as needed.

Processes, analyzes, audits, and finalizes claims adjudication results for pre-payment and post-payment reviews. Reviews claim attachments and medical documentation, identifies billing and system errors, applies CMS and NC Medicaid policies, and supports claims resolution. Provides phone and email assistance, training, and technical guidance to providers on claim submission, denials, system updates, and billing requirements. Reports suspected system issues to management.

Performs financial analysis, forecasting, auditing, and reporting to support business planning and decision-making. Applies accounting principles, develops financial models, prepares monthly expense and direct-cost summaries, and monitors financial performance metrics for trends and variances. The role requires analyzing financial data, evaluating payment arrangements, supporting compliance, and maintaining accurate financial reports. The position is remote within North Carolina, requires a valid driver's license and travel within the assigned catchment area.

Coordinates community outreach, advisory group meetings, education, and stakeholder engagement across an assigned North Carolina region. Builds partnerships, increases awareness of behavioral health and community services, educates internal and external partners, represents the organization at events, and distributes outreach materials. Requires relevant education or equivalent experience, a valid driver’s license, North Carolina residency within the organization’s catchment area, and travel throughout the region.

Coordinates the development, planning, oversight, and evaluation of training programs for the Children with Complex Needs workforce. Responsibilities include identifying training needs, creating plans and assessment tools, monitoring alignment with program goals, collaborating with leadership and stakeholders, and ensuring required staff training is completed. The role also evaluates outcomes, supports workforce development initiatives, and may provide technical assistance and implementation support to providers across the organization’s North Carolina catchment area.

Supports communications and marketing across digital, print, email, website, and media channels. Develops, writes, edits, and proofreads content; applies brand, accessibility, and readability standards; coordinates email distribution and reporting; supports print and digital material production; and maintains website content to ensure accurate, consistent, audience-appropriate messaging.

Manages the backlog and requirements for an enterprise technology product. Translates business needs into user stories and acceptance criteria, prioritizes work based on business value, conducts business analysis, collaborates with stakeholders and development teams, and participates in Agile ceremonies and delivery planning.

Lead clinical operations for LTSS programs, setting strategy and overseeing care management, clinical quality, compliance, and program performance. Manage managers and teams, develop and evaluate clinical policies and programs, ensure appropriate service delivery, and drive continuous improvement in member outcomes and regulatory adherence.

Processes and reviews accounts payable transactions, analyzes invoices, validates account coding, compares invoices with contract and policy requirements, resolves discrepancies, maintains payment documentation, and supports reconciliation activities. The role ensures accurate, compliant, and timely disbursement of funds and maintains financial record integrity. It is remote within North Carolina and requires a valid driver's license.

Manages appeals, grievances, and complaints from intake through resolution. Investigates cases by gathering records and interviewing stakeholders, evaluates findings, determines appropriate actions, prepares acknowledgment and resolution communications, and maintains compliant case files. The role supports regulatory and accreditation requirements within a managed care organization serving behavioral health, substance use, traumatic brain injury, and intellectual/developmental disability populations.

Supports utilization management by validating service authorization requests, checking documentation, obtaining missing information from providers, routing complete cases to clinical reviewers, monitoring authorization timelines, and tracking determinations in systems. The role serves behavioral health, substance use, traumatic brain injury, and intellectual/developmental disability populations. It is remote within North Carolina but requires travel within the assigned catchment area as needed.

Conducts compliance monitoring, audits, and investigations for internal stakeholders, providers, and vendors. Processes compliance cases from intake through resolution, evaluates findings, determines corrective actions, and monitors remediation effectiveness. The role ensures adherence to regulatory and contractual requirements and strengthens program integrity within a managed care organization serving behavioral health, substance use, traumatic brain injury, and intellectual/developmental disability populations.

Supports utilization management performance improvement through healthcare data analysis, dashboard and report development, data quality monitoring, stakeholder requirements gathering, and user training. Performs SQL- and BI-based analyses, interprets results for nontechnical audiences, develops reporting documentation and SOPs, and collaborates with clinical, business, IT, and informatics teams. The role is remote within North Carolina and requires travel within the service area as needed.

Provides peer support and transition assistance to adults with behavioral health or intellectual and developmental disabilities leaving incarceration. Responsibilities include care coordination, person-centered planning, warm handoffs, community resource navigation, housing and benefits support, treatment linkages, and collaboration with justice systems, care teams, families, and community providers.