Bon Secours Mercy Health

Director

• Provides strategic leadership, clinical oversight, and operational direction for behavioral health programs across the health system.
• Collaborates with executive leadership, physicians, nursing, and community partners to develop and implement integrated behavioral health strategies that align with the health system’s mission, regulatory requirements, and best practices.
• Serves as the system’s subject matter expert for all behavioral health services, policies, and initiatives.
• Identifies opportunities to expand access to care, improve clinical outcomes, and enhance patient experience.
• Monitors emerging trends, regulatory changes, and innovations in behavioral health to inform system strategy.
• Provides clinical leadership and direction to behavioral health programs, ensuring alignment with best practice models, clinical guidelines, and accreditation standards and system standardization.
• Collaborates with key stakeholders to ensure coordination and integration of behavioral health services throughout the continuum of care.
• Leads quality improvement initiatives focused on patient safety, outcomes, and experience.
• Ensures all behavioral health programs comply with applicable federal, state, and local regulations, as well as Joint Commission standards.

System Director – Behavioral Health

Events

• Supports the success of the Foundation Annual Programs and is responsible for planning, coordinating, and implementing Foundation events
• Works with a wide variety of internal and external contacts to plan and execute successful events
• Assists market foundation teams with solicitation of sponsorship funds to achieve foundation goals of philanthropic support
• Assists with planning, implementation, and production of all fundraising events including vendor relationships, budgets, and event logistics
• Coordinates work with external and internal audiences including vendors and donors
• Provides administrative support in the research and solicitation of new and existing donors to support Foundation special events
• Represents the organization in a positive manner at all times, including working with staff, volunteers, and vendors

Special Events Coordinator

Risk

• Participates in the risk analysis to determine effective loss prevention activities then implements loss prevention activities, including education, related to both clinical and non-clinical policies as directed by the System Director.
• Assists with collection of underwriting information including collecting data needed for the captive, reinsurance, physician, and multiple commercial insurance policy renewals and bonds and maintains this data for historical purposes.
• May also attend underwriting meetings if scheduling permits.
• Assists with maintaining databases of insured entities, properties, vehicles, drivers, physicians, etc. in the risk management information system.
• Assists with policy review, creating and maintaining schedules of insurance, premiums, policy summaries, etc.
• Works with facilities, practice managers, real estate, finance, human resources, and other internal departments to manage certificate of insurance requests.
• Works with facilities, practice managers, real estate, finance, human resources, and other internal departments to assist with requests for bonds.
• May assist with special projects.

Risk and Insurance Intern

Manager

• Provides in-person guidance and support to the providers, care teams, and affiliates in clinical integration initiatives
• Completes In person and virtual rounds in the practices on a regular basis to communicate status reports, key drivers of change, leading or lagging indicators, and providing insights to providers and practices
• Manages the review of clinical outcomes, patient panel management, and performance metrics for affiliates and employed physicians in the assigned market or Region’s network
• Partners with providers and care team members to implement evidence-based protocols and other improvement initiatives based on the insights
• Conducts provider orientation and facilitates onboarding and offboarding of providers into the assigned network

Clinical Outcomes Manager – Population Health

Medical Billing and Coding

• Reviews medical record documentation and assigns appropriate ICD-10 diagnoses and procedure codes
• Assists with writing appeals for Diagnosis Related Group (DRG) denials
• Collaborates with Clinical Documentation Specialists and medical staff
• Ensures accurate coding for code assignment

Inpatient Coder

• Advanced outpatient coding position that reviews medical record documentation and accurately assigns ICD-10-CM, ICD-10-PCS, as well as CPT IV codes based on the specific record type and abstract specific data elements for each case in compliance with federal regulations.
• Codes all types of outpatient visits to include ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures.
• Follows the Official Guidelines for Coding and Reporting, the American Health Information Management Association, (AHIMA,) Coding Ethics, as well as the American Hospital Association, (AHA) Coding Clinics, CMS directives and Bulletins, Fiscal Intermediary communications.
• Utilizing Coding Applications in accordance with established workflow.
• Follows Mercy Policies and Procedures and maintains required quality and productivity standards.
• Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and premise as a team, ensure timely, compliant processing of outpatient claims in the billing system.
• Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computerized Assisted Coding, (CAC,) Medical Necessity software, abstracting system, code books, and all reference materials.
• Reports inaccuracies found in Coding Software to HIM Management/Supervisor, reports any potential unethical and/or fraudulent activity per compliance policy.
• Attends required system, hospital and departmental meetings and educational sessions as established by leadership, as well as completion of required annual learning programs, to ensure continued education and growth.

Outpatient Coding Specialist

Therapist

• Review physician referrals and patient medical history to determine therapy needs.
• Conduct and document patient evaluations, re-evaluations, and treatment plans according to department protocols.
• Administer prescribed occupational therapy treatments and create custom equipment for individual needs.
• Develop programs focusing on functional skills, vocational training, daily activities, and motor skills.
• Monitor progress and adjust treatment goals and plans as necessary, participating in patient care conferences.
• Educate patients and families on at-home treatment procedures.

Occupational Therapist – PRN

• Provide leadership for the strategic design and implementation of a system-wide laboratory stewardship program.
• Ensure that laboratory testing—both in-house and send-out—is used appropriately, efficiently, and cost-effectively to improve patient care.
• Reduce unnecessary variation in testing, improve testing performance, and enhance financial sustainability.
• Drive clinical integration by expertly combining decision analytics with Lean Six Sigma methodologies.
• Lead and manage the laboratory stewardship program across Bon Secours Mercy Health, aligning with value-based care initiatives and population health strategies.
• Develop and monitor key performance indicators (KPIs) related to test utilization, productivity, turnaround time, and cost per test for both in-house and referral tests.
• Develop and chair a utilization management review committee and partner with the prior authorization team.
• Review high-cost and high-volume referral tests for clinical appropriateness and develop test algorithms, where applicable.
• Prepare business case proposals on appropriate buy vs sell initiatives of tests that can be internalized.
• Track and analyze test ordering trends to identify overuse, underuse, or misuse, and provide education and feedback to clinicians on evidence-based testing.
• Apply Lean, Six Sigma, and other quality systems/continuous improvement methodologies to evaluate the need for new testing and equipment submitted by markets.
• Collaborate with physicians, pathologists, informaticists, and operational leaders to develop guidelines for appropriate test ordering.
• Act as the BSMH lab’s point person for vendor relations and business reviews of reference laboratories and blood suppliers.

Director, Lab Stewardship – Test Optimization

Payroll

• Responsible for the accurate calculation of a centralized employee multi-state payroll including tax filing and remittance, vendor payments and paycheck/paystub distribution
• Support efforts to ensure Payroll systems pay practices are compliant with FLSA and DOL requirements
• Oversee payroll funding requirements and interfaces, work directly with Treasury department to ensure accurate and timely disbursement of payroll funds
• Lead, coach and develop direct reports. Ensure uniform process for measuring employee competency in Payroll related areas.
• Develop and maintain standards and content for Payroll related educational materials and documentation for the consolidated payroll team.
• Coordinate staff training to ensure integration of defined standards into operational processes.
• Work collaboratively with Systems HR, Payroll and Finance leaders to ensure local system needs are accommodated to the extent possible under the standardized model while facilitating sharing of best practices across BSMH.
• Collaborate with appropriate resources responsible for Time and Attendance system to ensure the application is functioning as expected and is compliant with FLSA, DOL, and state pay requirements.
• Provide detailed Payroll Metrics and Reporting to Senior level management for key monthly statistical data.
• Support the ongoing standardization and centralization efforts across BSMH, based on value, efficiencies, best practice to position the department for strategic growth.
• Work with Payroll Systems Manager and Analysts to develop internal controls for the in-house payroll system.
• Write and assist with completion of all control, processes, and functions documentation.
• Ensure all processes remain current with changes to DOL, FLSA and other pay practice compliance regulations.
• Knowledge of International, and Non-Resident alien forms, compliant W-4 form completion, and tax withholding requirements.
• Knowledge of regulations around special clergy tax scenario for set up in the Payroll System

Payroll Operations Manager

Clinical Operations

• Leads system-wide population health projects and initiatives: identifying appropriate interventions and strategic solutions, leading change management planning efforts on assigned projects with the initiative owner(s), developing implementation plans and operational workflows, communication with stakeholders and executive leadership, anticipating change management needs, and plans for mitigating barriers.
• Provides subject matter expertise regarding value-based quality measures to system-level leaders, including enhancing value-based contract performance with the identification and validation of clinically relevant data.
• Leads the overall development, implementation, and delivery of the Population Health Clinical Quality strategic plan, including support of additional value-based lives, strategic growth, and identification of gaps across the continuum of care, while maintaining alignment with the overall ministry goals.
• Directs and leads a team of Population Health Coordinators in defined workflows to support quality outcomes and performance within BSMH’s value-based care programs.
• Maintains operational oversight and accountability for Population Health patient outreach activities including affiliate provider partnerships and vendor management.

Clinical Quality Manager – Population Health

• Manage successful statewide relations at all levels of government and among community leaders, state trade associations and other external constituents
• Support system-wide legislative, regulatory and advocacy priorities in the State of South Carolina
• Manage government relations/advocacy agenda on a statewide basis
• Foster and influence relationships resulting in favorable legislative & regulatory outcomes
• Provide legislative, regulatory and health industry intelligence to inform strategic impact analyses
• Create effective grass-tops and grassroots support for legislative and advocacy issues
• Partner with internal Foundation personnel to identify local, state and federal grant opportunities
• Lead and manage local market / regional Advocacy outreach in Greenville and in Charleston
• Maintain registration as a state lobbyist on behalf of BSMH

Director – Government and External Relations

• Provides in-person guidance and support to the providers, care teams, and affiliates in clinical integration initiatives that supports the quadruple aim and allows the organization to thrive in a value-based health care model.
• Completes In person and virtual rounds in the practices on a regular basis to communicate status reports, key drivers of change, leading or lagging indicators, and providing insights to providers and practices
• Manages the review of clinical outcomes, patient panel management, and performance metrics for affiliates and employed physicians in the assigned market or Region’s network
• Partners with providers and care team members to implement evidence-based protocols and other improvement initiatives based on the insights, monitors ongoing progress, document supports, identify resources, and engages care delivery team
• Maintains being a professional role model in practice transformation and under leadership guidance, effectively engages and educates regional stakeholders on the elements, measures, tasks, and tools to be used to support various practice improvement activities
• Conducts provider orientation and facilitates onboarding and offboarding of providers into the assigned network as related to panel management and other Clinical Integration key initiatives
• Supports, encourages, and works closely with providers, their care teams and regional practice leaders to implement process and quality improvement activities and workflows necessary for successful participation in value-based agreements
• Collaborates with Regional and practice staff to facilitate the market implementation of assigned network initiatives and facilitates process improvement activities in support of Clinical Integration initiatives
• Conducts chart audits in support of annual quality composite audits with Affiliates not on Epic in support of Mercy Health Select and any other future distributions and chart reviews or quality audits under the direction of System or Regional clinical leadership for the purposes of supporting quality patient care and success in current and future initiatives
• Facilitates provider remediation tracking and activities in collaboration with assigned network leadership and the assigned medical and quality leadership
• Effectively engages in relationship management to support the ministry outcomes and delivery of care

Recruitment

• Responsible for ongoing optimization and support of the Resource Optimization Centers (ROC)
• Collaborates with ROC leaders, Human Resources Technology & Systems, and others to recommend workflow and technology optimizations
• Attends staffing and scheduling councils to review challenges, successes, best practices and develops recommendations
• Provides expert input into training materials for staffing, scheduling, and timekeeping process
• Provides technology training to new nurse leaders and others
• Optimizes ROC standard operating procedures (SOP's) using experience and evidence-based practice
• Assists with adding new departments to ROC oversight- technology configuration and resource needs
• Evaluates and makes recommendations for optimization of technology through analyzing reports and trends
• Monitors and evaluates ROC KPI’s and identifies areas of opportunity
• Produces reporting for ROC metrics and technology utilization

Staffing and Scheduling Program Coordinator

• Evaluates patients, gathering pertinent information from various sources, and develops an appropriate treatment plan with specific goals.
• Responsible for ongoing assessment, efficiency of treatment plan and revisions of plan as needed.
• Provides direct therapy to patients daily following patient’s plan of care and current standards of practice for Physical Therapy.
• Provides instruction in therapeutic procedures to patients and family.
• Maintains accurate and concise records on treatment provided and patient's progress.
• Documents all care provided, coordination of services, orders, goals, etc. in the patient’s electronic medical record in an accurate and timely manner.
• Provides timely co-signature for supervised physical therapy assistants, if applicable.
• Maintains set level of productivity without jeopardizing quality.
• Delivers efficient and effective care to patients meeting and exceeding department standards.
• Maintains departmental policies and procedures regarding safety, infection control, time off requests and timecard recording.
• Supervises the physical therapist assistant’s treatment interventions and professional growth.

System Director – Behavioral Health

Special Events Coordinator

Risk and Insurance Intern

Clinical Outcomes Manager – Population Health

Inpatient Coder

Outpatient Coding Specialist

Occupational Therapist – PRN

Director, Lab Stewardship – Test Optimization

Payroll Operations Manager

Clinical Quality Manager – Population Health

Director – Government and External Relations

Clinical Outcomes Manager – Population Health

Staffing and Scheduling Program Coordinator

Physical Therapist, Inpatient