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合规护士

雇主

Trillium Health Resources

地点

远程 · Remote · 美国

待遇

$USD 68,890 - USD 92,138 / annual

工作模式

远程

截止日期

1月6日

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岗位摘要

Pay Plan Title:Compliance Nurse Working Title:Compliance Nurse FLSA Status:Exempt Posting Salary Range:$68,890 - $92,138 Office Location:Remote within North Carolina POSTING DETAILS:Make an ImpactTrillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina.

岗位职责

Pay Plan Title:Compliance Nurse
Working Title:Compliance Nurse
FLSA Status:Exempt
Posting Salary Range:$68,890 - $92,138
Office Location:Remote within North Carolina
POSTING DETAILS:
Make an Impact
Trillium Health Resourcesis 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.
Why Work for Us?
Trillium believes that empowering others begins with supporting our team. We offer our employees:
A collaborative, mission-driven work environment
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.
If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!
What We’re Looking For
Trillium Health Resourceshas a career opening for a Compliance Nurse to join our team! The Compliance Nurse performs clinical compliance reviews and evaluates claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine compliance, and direct corrective actions to prevent improper payments and support program integrity.
On a typical day, you might:
Conduct clinical reviews of pre- and post-payment claims to verify compliance.
Evaluate clinical documentation against coverage policies and service definitions.
Apply independent clinical judgment to determine compliance and identify discrepancies.
Manage assigned compliance cases from intake through resolution.
Investigate allegations of non-compliance.
Evaluate case findings and determine appropriate corrective actions.
Maintain complete case files in accordance with regulatory and accreditation standards.
Employee Benefits:
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 available for some positions 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
NC Local Government Retirement Pension (defined-benefit plan)
401k with 5% employer match and immediate vesting
Public Service Loan Forgiveness(PSLF) qualifying employer
Quarterly stipend for remote work supplies
Qualifications
Required:
Associate's degree in Nursing and one (1) year of experience with physical health or behavioral health, mental health, substance use, developmental disabilities, and/or co-occurring disorders populations or field.
Active North Carolina Licensureas 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:
Experience in both physical healthcare and behavioral healthcare.
Experience in clinical healthcare audits, monitoring or reviews.
Deadline for Application:Friday, October 16, 2026 at 11:59pm
How to Apply
To be considered, submit your application and resume through our ADP Career Center. Your resume must include:
Employer name, dates of service (month/year), average hours worked per week, and essential job duties
Education details (degree type, date awarded, institution, field of study)
Licensure/certification information, if applicable
After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You’ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.
Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.
Trillium Health Resourcesis an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.
#Innovation #Technology #Careers #NorthCarolina #BehavioralHealth
Originally posted on Himalayas

申请条件

- 注册护士(RN)执照
- 具有临床审查或合规审查相关经验
- 能够评估临床文档并对照覆盖政策和定义进行判断
- 具备独立临床判断能力
- 有管理合规案件从受理到解决的经验
- 了解监管和覆盖要求
- 能够识别差异并指导纠正措施以防止不当支付
- 位于北卡罗来纳州(远程办公要求)

雇主简介

Trillium Health Resources是一家管理式医疗组织(MCO),为北卡罗来纳州46个县提供定制化计划,管理严重心理健康需求、物质使用障碍、创伤性脑损伤和智力/发育障碍(IDD)患者的服务。

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数据来源:Himalayas

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