About this opportunity
Trillium Health Resources lists this Compliance Nurse opportunity in raleigh, North Carolina. Review the employer’s description below for duties, qualifications and application requirements.
Job description
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 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.
Why Work for Us?
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,
What We’re Looking For
Trillium Health Resources has 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.
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) systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook401k 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 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
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
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.
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Worksite address
raleigh, NC, 27601, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.