Review Specialist, Transitions to Community Living (TCL)

Remote, North Carolina

What you’ll do:

Constellation Quality Health seeks a Review Specialist to conduct reviews of the North Carolina Transitions to Community Living support services provided to eligible Medicaid participants throughout the State of North Carolina (NC). In partnership with the NC Department of Health and Human Services (DHHS) Transitions to Community Living, Review Specialists will conduct program monitoring and review of identified metrics to ensure Medicaid beneficiaries receive high quality transition support and have access to quality services.

We expect you to:

• Conduct desk and onsite reviews of the TCL program and services provided by community care facilities, Local Management Entities/Managed Care Organizations (LME/MCOs), Adult Care Homes (ACH) and/or the State Psychiatric Hospitals
• Document findings for submission to DHHS
• Provide Technical Assistance (TA) and guidance based on review findings and contract requirements where appropriate
• Assist with the development of review methodologies, quality metrics, data collection tools, and dashboards
• Remain current with local policies and procedures to ensure state compliance with TCL requirements as required by the Olmstead Act Settlement Agreement.

Candidates will primarily work remotely; however regional travel in NC is REQUIRED. Candidates in the western region of NC will be given preference.

Who you are:

Successful candidates will have experience working with LME/MCOs, and mental health providers of different levels of care and with individuals who require community-based and transition services. Additionally, the candidate must have experience and expertise in writing detailed professional reports.

Our requirements for this role:

• Graduate of accredited college or university, with degree in Social Work, Public Health, Psychology, Nursing or related health and human services field. Master’s Degree preferred.
• Licensure preferred (but not required) – Master’s-level fully Licensed Clinical Social Worker (LCSW), fully Licensed Clinical Mental Health Counselor (LCMHC), fully Licensed Psychological Associate (LPA), fully Licensed Marriage and Family Therapist (LMFT), fully Licensed Clinical Addiction Specialist (LCAS), or licensure as a Registered Nurse (RN).
• Five years of experience required in at least one of the following:
  • Community-based supported housing
  • Community-based mental health services
  • Employment placement services serving the relevant population
  • Discharge and transition services
  • Pre-admission screening
  • ACH or inpatient behavioral health hospitals
  • Quality assurance in TCL related tasks and activities
• Experience coordinating care transitions
• Ability to function independently and as part of a team
• Superior written and oral communication skills
• Ability to write detailed professional reports

Why Constellation Quality Health:

• We offer a competitive salary and benefits package and a flexible, supportive work environment.
• Equal opportunity employer of protected veterans.
• Equal opportunity employer of individuals with disabilities.
• We do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, gender identity, national origin, medical condition, disability, veteran status, or any other basis protected by law.
• Applicants and employees are protected from discrimination based on inquiring about, disclosing, or discussing compensation or the compensation of other applicants or employees.