Utilization Management Nurse – Physical Health

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Full Time Professionals
* Trillium office based location as specified below: US 2 Attachments

Salary Range: $68,890.00 To $92,138.00 Annually

FLSA Status: Exempt

Posting Salary Range: $68,890 - $92,138

Office

Location:

Remote within North Carolina.

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/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.

Trillium believes that empowering others begins with supporting our team. We offer our employees:

• Competitive benefits and work-from-home options for most positions
• Opportunities for professional growth in a diverse inclusive culture

Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.

Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.

Trillium Health Resources has a career opening for a Utilization Management Nurse to join our Utilization Management team! The Utilization Management Nurse performs clinical reviews and coordinates care to ensure appropriate use of services and effective care transitions. The role evaluates clinical information, collaborates with providers, and supports discharge planning to improve outcomes and continuity of care.

• Conducts prospective, concurrent, and retrospective clinical reviews using established criteria.
• Assess clinical information to determine medical necessity and level of care.
• Collaborates with providers and facilities to support treatment planning and discharge coordination.
• Performs admission and concurrent reviews to monitor ongoing care needs.
  
  Identifies cases requiring physician review and presents clinical recommendations.

Trillium knows that work/life balance is essential. That’s why we offer:

• Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval.
• Work-from-home options available for most positions
• 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
• 401k with 5% employer match and immediate vesting
• Public Service Loan Forgiveness (PSLF) qualifying employer
• Quarterly stipend for remote work supplies

Required:

• Associate's degree in Nursing and two (2) years of Utilization Management/Review, to include clinical acute inpatient care (ER, ICU, Med-Surg), behavioral health, compliance, or evidence-based clinical decision support tools.
• Active North Carolina Licensure as a Registered Nurse (RN).
• Must have a valid driver’s license.
• Must reside within North Carolina.
• Must be able to travel within catchment as required.

Preferred:

• Clinical experience in a managed care organization, health plan or hospital setting.

GOVCL
004 - UTILIZATION MANAGEMENT

Tips for Applying to or Interviewing with Trillium 2.3.26 .pdf