Bon Secours Mercy Health

Account Manager

• The Senior Associate Relations Manager is responsible for leading a team of Associate Relations Managers supporting various markets.
• Coach team members on associate relations skills and focus on development of team members' subject matter expertise.
• Resolve issues at the lowest level possible.
• Work directly with various leadership levels from front line leaders to higher level leadership up to executives.
• Guide and support leadership in complex and high-risk associate relations decision making.
• Handle a case load and effectively manage the review, resolution and documentation of code of conduct related matters and policy violations.
• Lead a team of Associate Relations Managers who manage the documentation of code of conduct related matters and policy violations.
• Support and guide Associate Relations Manager in handling employment concerns, providing quality customer service.
• Provide strategic Associate Relations support, business partnership, and coaching to all levels of the ministry.
• Demonstrate a change management mindset through process and policy improvement to enhance employee experience.

Senior Associate Relations Manager

Auditor

• Conducts independent compliance investigative audits requested by Legal or Leadership and as part of the Compliance due diligence during merger and acquisition activity
• Assists in the preparation of audit reports for presentation to Legal or Leadership and presents findings and proposed action plans
• Performs investigative audits and assists with response and development of corrective action plans stemming from governmental reviews and inquiries
• Performs annual compliance workplan provider revenue cycle audits and projects related to the European Group
• Assists in the quality review of Bon Secours Mercy Health coding, billing, and claims processing to ensure compliance with policies
• Assists in and tracking of all activities related to recovery and repayment of inappropriate payments discovered as a result of claims audit or investigation
• Demonstrates advanced industry and audit knowledge and is recognized as a subject matter resource for the team and the ministry
• Performs research, creates presentations, and otherwise supports the Revenue Cycle Compliance team with developing written reports, educational materials, and trending dashboards
• Utilizes data analytics and extraction for developing trends, metrics and dashboards related to external audit activity of governmental agencies, denials, or regulatory changes
• Conducts and assists with routine provider revenue cycle monitoring initiatives established from data analytics
• Acts as a Superuser for audit and compliance applications and platforms
• Develops standard operating procedures (SOPs) and process workflows to ensure standardization across the ministry
• Responsible for training new staff on audit processes, systems, coding guidelines (to include annual and periodic coding changes), and regulatory changes impacting revenue cycle
• Provides guidance and serves as resource to auditing staff regarding SOPs, coding questions, audit findings, and audit report development
• Ensures that Revenue Cycle Compliance leadership is apprised of local, remote and emerging issues, adverse outcomes or deficiencies that could impact Bon Secours Mercy Health's public status
• Maintains awareness of fraud, waste, and abuse laws and regulations and current industry changes that may impact healthcare revenue cycle services domestic and international through personal initiative, continuing education and peer-to-peer networking
• Displays a commitment to excellence, accuracy, and thoroughness in all activities and searches for way to improve and promote quality

Senior Compliance Auditor

Manager

• Oversees and directs staff, formulating and implementing patient care policies and standards of care for patients
• Prepares Commission on Cancer Accreditation (CoC) American College of Radiology (ACR) surveys
• Plans, implements, and evaluates designated oncology services and administrative operations
• Oversees budgetary parameters and daily productivity metrics
• Establishes and maintains patient care protocols and standards, ensuring compliance with federal and state regulations
• Develops and implements quality improvement, safety, and patient care programs
• Supervises and evaluates clinical staff
• Participates in policy development, long-term planning, and project implementation

Cancer Center Manager – Oncology

Medical Billing and Coding

• Trauma Registry must provide timely data entry of all trauma patients admitted to or transferred.
• Must meet all requirements of the Ohio State Trauma Registry and the Northwest Ohio Regional Trauma Registry.
• Facilitate reports according to predetermined specifications.
• Develop strong relationships with patient care providers, physicians and community resources.
• Utilize data entry programs effectively and coordinate data within various data systems.

Trauma Registrar Coding Specialist

• In collaboration with Market President, responsible for incremental improvement of in-network utilization through growth in new patient referrals across the BSMH Product Portfolio.
• Uses data to make informed decisions that guide a strategic call plan that delivers high impact face-to-face visits each month.
• Conducts face to face visits with physicians, providers, and influencers to inform them of new services and/or changes in care delivery to optimize care coordination of in-network offerings for empaneled patients.
• Identifies barriers and facilitates resolution improving care delivery, often resulting in substantial process change and/or new service offerings.
• Convenes market stakeholders to discuss and address competitive threats, performance improvement opportunities, and product differentiators to enable incremental growth.

Physician, Provider Relationship Manager

Director

• Leads strategy development and overall implementation of information and knowledge critical to meeting the system's strategic goals and initiatives.
• Ensures the validity and replicability of data analytics and sources.
• Provides support to Marketing on the development of consumer primary and secondary research.
• Recommends and implements strategies and methodologies to strengthen strategic planning and business development analytic methods and solutions.
• Identifies and utilizes internal and external resources to reproduce, evaluate, research, and improve techniques.
• Develops measurement and evaluative tools for system, especially in area of Service Lines, Physician Provider Relations, Ambulatory Services, Consumer Insights and Business Development.
• Manages assigned staff and serve as a convenor of strategy analyst for training, professional development, and best practice sharing.
• Provides consultation to System and Strategy executive leadership.

System Director – Strategic Analytics

• Provide care to patients discharged to post-acute facilities and maintain a caseload according to productivity standards
• Perform and coordinate work with the patient, family or support members, inpatient case management team, and interdisciplinary care team members
• Communicate regularly on post-acute care of specific patients, as well as population level care and performance
• Run daily reports for transitions of care, make assignments, and review goals of care
• Communicate at minimum weekly with skilled nursing facilities to encourage progression of care within an appropriate length of stay
• Evaluate effectiveness of care plan with Interdisciplinary Team (IDT)
• Conduct comprehensive assessments and complete required documentation
• Perform patient outreach according to established protocols and document in electronic medical record
• Coordinate referrals and transitions of care from one provider to another or from one care setting to another
• Provide Patient and Family or Caregiver education
• Refer to appropriate next level of care and discharge planning with facility, patient, and family or caregiver
• Conduct monthly meetings with high volume facilities on overall performance, quality, and readmissions

Post-Acute Care Manager – Population Health

Accountant

• The Senior Staff Accountant is responsible for providing accounting and financial support to ensure adequate internal controls and efficiency of procedures and processes within the Accounting department.
• This role will ensure the accuracy of financial reporting and accounting.
• Maintains general ledger accounts in accordance with generally accepted accounting principles and organization policy and researches exceptions.
• Prepare journal entries for month end close.
• Prepare or assists with more complex journal entries.
• Approve other staffs entries for posting.
• Performs an analysis of the overall income, statement, identifies variances to budget, researches and provides explanations for identified variances.
• Prepare balance sheet reconciliations in Blackline monthly and attached support documents for items >$50k.
• Research and clear items over 90 days old.
• Approve other staffs reconciliations and assist with resolving issues.
• Assist with accounts receivable subsystem variance resolution.
• Proficient and understand how all systems work together and can assist others with questions.
• Is a subject matter expert for a system and assists with training staff on new or functionality or refreshing current knowledge of systems.
• Oversees the process improvement team and implementation.
• Holds periodic Accountant meetings and provides feedback to Manager.
• This meeting covers suggested process improvements, things that are work problems for staff, roll out of new implementations or accounting policy changes.
• Assists the Accounting Manager during close and is available to cover for them in their absence.
• Liaison with local system financial planning and analysis team.

Senior Staff Accountant

Risk

• Effectively and efficiently manages liability claims, including hospital and employed physician claims
• Acts as BSMH representative at pre-trial hearings, mediations, arbitrations, and trials
• Manages and directs defense counsel in accordance with organizational objectives and goals
• Independently evaluates, reserves, and resolves claims and litigated matters within designated authority
• Utilizes risk investigations and expert reviews to evaluate legal liability and causation
• Assigns appropriate defense counsel depending on venue, claim type, and potential claim value
• Works closely with insurance staff when coverage issues arise
• Sets accurate financial reserves based on experience and reserving formula in a timely manner
• Works closely with market and group senior leaders to explain the evaluation of risks and alternatives

Claims Manager – Risk and Insurance

Program Manager

• Coordinates daily operations within department, with functions related to healthcare ethics, palliative care and advance care planning (ACP).
• Provides recommendations on the clinical pathways to improve reliable and effective ACP for Well, Rising Risk, and Seriously Ill patient populations.
• Monitors and measures progress toward the achievement of departmental, programmatic, and system goals.
• Establishes strong, consistent relationships with community organizations and key internal and external stakeholders; to provide leadership to pilot/implementation project site leaders and better acquaint the system with the programs offered through the department.
• Implements system level Advance Care planning processes as they relate to the goals of Care Transformation, Population Health, and Serious Illness programs.
• Using clinical expertise, optimizes effectiveness of patient education and engagement strategies to promote patient understanding and positive experience with early, proactive consideration of care preferences and care planning.
• Participates in operational and clinical improvement initiatives that increase the effectiveness and efficiency of ACP processes across the care continuum.
• Provides education to care teams in order to improve patient, clinician and provider experience of advance care planning and serious illness care.
• Collaborates with other TOC groups to embed ACP throughout system initiatives.
• Functions with high level of accountability, steadfast quality focus, teamwork, coordination, continual improvement, and care innovation.

Program Manager – Advance Care Planning, Population Health

• Partner with internal and external stakeholders to identify local community health issues, priorities, and opportunities with an emphasis on health equity, economic and community development, community engagement, holistic health, and well-being.
• Ensure community health programs meet regulatory requirements, industry best practices and are a collaborative endeavor including community partners and community members.
• Initiate and mature programs and partnerships aligned to the organization’s Community Health strategy.
• Develop effective relationships with community leaders and residents across diverse interests, cultures, and socio-economic backgrounds.
• Continuously engage local stakeholders and community residents to identify local issues, priorities, and opportunities for partnership.
• Represent the organization at local task forces, community coalitions and advisory groups.
• Compile and report community benefit data and prepare reports with evaluation metrics to share with senior leadership.
• Develop funding priorities, application and review processes, and ongoing expectations for funded partners.

Community Health Impact Manager

Medical Director

• Provide clinical leadership for pathology services across Bon Secours Mercy Health laboratories.
• Ensure reliable quality patient outcomes and KPIs are standardized across laboratories.
• Assure compliance with all applicable regulatory agencies.
• Drive alignment of market pathology priorities with the organization’s mission and goals.
• Oversee pathology operations across multiple hospital-based and ambulatory laboratories to ensure efficiency, consistency, and service excellence.
• Develop and standardize pathology productivity and performance metrics across the ministry.
• Guide market medical directors in the development and review of quality assurance programs.
• Conduct performance evaluation of all market medical directors and input in the evaluation of site medical directors.

System Medical Director – Pathology Services

Project Manager

• Communicate effectively with internal and external stakeholders.
• Assist in developing project scope and budgets for approval.
• Manage multiple projects concurrently, ensuring adherence to construction practices, specifications, and regulations.
• Identify and resolve construction issues, ensuring minimal disruption to patient care and operations.
• Collaborate with Infection Prevention, Facilities Engineering, and relevant departments for risk assessments and safety measures (Pre Construction Risk Assessment, Infection Control Risk Assessment, Interim Life Safety Measures).
• Maintain accurate financial tracking and project documentation using project management software.
• Oversee the commissioning process to ensure compliance with specifications.
• Facilitate purchasing, contract management, and timely payment processing.
• Coordinate with IT and procurement to align materials and services with project schedules.
• Provide clear reporting on project status, risks, and financial performance.
• Support the continuous improvement of design and construction processes.

Construction Project Manager

IT Support

• Works collaboratively with the Director, Compliance on creating auditing and monitoring protocols that align with Bon Secours Mercy Health’s overall compliance audit and compliance responsibilities relative to acute and physician revenue cycle services performed for Bon Secours Mercy Health.
• Oversees acute and provider compliance audits including work plan items, management requests, Merger and Acquisition due diligence coding audits and assessments, and responses to governmental audits and inquiries.
• Assesses and makes recommendations to improve internal controls and policies and procedures for both acute and provider Revenue Cycle operations including the development of SOPs.
• Develops acute and provider compliance monitoring and audit protocols specific to revenue cycle compliance risk areas.
• Coordinates periodic review and analysis of Bon Secours Mercy Health provider claims denial reports, operational assessment reports, internal quality control reviews, internal and external third-party claims payment peer analysis systems to detect provider-billing trends.
• Utilizes data analytics techniques, statistical analysis and modeling, and databases developed internally, or in conjunction with other third-party vendors to detect and trend potential claims and billing compliance issues.
• Assists in the development of corrective action plans (CAP), oversight tools and technical edit enhancements to support acute and physician revenue cycle services operational efforts.
• Assists in tracking of all activities related to recovery and repayment of inappropriate payments discovered as a result of claims audit or investigation.
• Maintains awareness of regulations and current industry changes that may impact healthcare physician revenue cycle services domestic and international through personal initiative, continuing education and peer-to-peer networking.
• Ensures that the Director, Compliance is apprised of local, remote and client-network emerging issues, adverse outcomes and/or deficiencies that could impact Bon Secours Mercy Health's public status.
• Develops educational content and trending of non-compliant activities to enhance proficiency and competency, understanding of standards and the consequences of non-compliance.
• Prepares multi-faceted oral, written and electronic communications and presentations to facilitate discussion, networking, decision-making and proactive responses to meet current and emerging challenges among affected parties and entities

Compliance Audit Manager

• 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.