Connections Health Solutions

Risk

• The Risk & Quality Specialist works in collaboration to coordinate, administer and oversee the onsite quality and risk management programs.
• This role will manage, analyze and interpret both risks and performance data to drive key performance measures (KPMs), provides risk and quality education, and comply with Joint Commission standards and other regulatory agencies, with the goal of enhancing and promoting recipient safety, quality of care and minimizing losses to the organization.
• Acts as the Quality Improvement and Risk Management subject matter expert at the site(s), and within committees and associated workgroups.
• Serves as a point of contact for investigation, resolution, and response of internal recipient and external (i.e., Health plan) complaints.
• In addition, may coordinate with the Director of Licensing and Accreditation on responses to complaints received from the Joint Commission or other Regulatory agencies.
• Works with the site-based staff and facilities to ensure all incidents are documented and reported as required to external regulatory bodies.
• Leads initiatives, in collaboration with site leadership and national Quality leadership, that support improvement of organizational processes for clinical care delivery, business operations and administration.
• Works in conjunction with all necessary individuals and departments in the investigation of potential or actual events concerns, including the auditing of seclusion and restraint footage when necessary.
• Coordinates and participates in root cause analysis investigations as appropriate.
• Exercises discretion and independent judgement on identifying opportunities for improvement and driving performance outcomes, this includes identifying opportunities to prevent, reduce, and control loss to the organization, its patients, visitors, and employees.
• Coordinates with leadership to develop strategies, implement practices, and assists with the creation policy to address the identified areas of improvement.
• Coordinates, tracks, and monitors performance and process improvement outcomes, as well as data tracking and trending analysis.
• Completes and documents facility inspections every 6 months, or as needed, to identify areas of risk and/or improvement to ensure compliance with regulatory/accreditation standard.
• Coordinates with the appropriate departments regarding site visits or audit requests from state Health regulatory agencies or accrediting bodies.
• Communication with state regulators, when needed, to inquire about state-specific requirements.
• Assist with creating policies to reflect company vision and mission under direction and in collaboration with department leadership.
• Stays abreast of the latest developments, advancements, and trends in the field.
• Performs all other duties as assigned.

Risk & Quality Specialist

• Coordinate, administer and oversee the onsite quality and risk management programs
• Manage, analyze and interpret both risks and performance data to drive key performance measures (KPMs)
• Provide risk and quality education, and comply with Joint Commission standards and other regulatory agencies
• Enhance and promote recipient safety, quality of care and minimize losses to the organization
• Acts as the Quality Improvement and Risk Management subject matter expert at the site(s)
• Serve as a point of contact for investigation, resolution, and response of internal recipient and external (i.e., Health plan) complaints
• Coordinate with the Director of Licensing and Accreditation on responses to complaints
• Work with site-based staff and facilities to ensure all incidents are documented and reported
• Lead initiatives that support improvement of organizational processes for clinical care delivery, business operations and administration
• Coordinate and participate in root cause analysis investigations
• Identify opportunities for improvement and driving performance outcomes
• Develop strategies and assist with the creation policy to address the identified areas of improvement
• Tracks and monitors performance and process improvement outcomes
• Complete and document facility inspections to identify areas of risk and/or improvement
• Communicate with state regulators, when needed, to inquire about state-specific requirements
• Assist with creating policies to reflect company vision and mission

Human Resources

• The Human Resources Business Partner (HRBP) partners closely with leadership, clinicians, and employees to align HR strategy with business and patient goals
• Will serve as a trusted advisor and strategic partner to leaders and staff
• This role provides consultative support on workforce issues that directly impact operational strategy, patient care, and organizational effectiveness
• Acting as the primary point of contact for assigned client groups, the HRBP delivers expertise in workforce planning, policy interpretation, employee relations, compliance, employment law and HR fundamentals while ensuring ease of access to HR deliverables
• The HRBP plays a critical role in shaping and scaling the people function within a fast-growing behavioral health organization
• By leveraging data-driven insights, coaching leaders, and driving HR best practices, the HRBP fosters a resilient, engaging culture that supports mental health professionals in high-growth, high-impact environments
• This position will include light travel.

HR Business Partner

Learning and Development

• Designing and implementing initiatives that strengthen organizational culture, enhance employee engagement, and build leadership and professional capabilities across the workforce
• Supports talent management and performance programs that foster retention, career growth, and organizational effectiveness
• Partners with leaders and HR to drive programs that inspire employees, improve performance, and reinforce organizational values
• Supports the implementation and delivery of leadership development programs for emerging and established leaders
• Gathers and analyzes feedback to evaluate program effectiveness and recommend improvements
• Supports performance management processes including goal setting, mid-year and annual reviews, and calibration sessions
• Analyzes engagement, recognition, retention, and learning program metrics to measure success and identify improvements

Employee Engagement and Learning Specialist

Project Manager

• The Project Manager will manage all aspects of a project for cross-functional teams.
• The Project Manager is responsible for the management of major implementation initiatives, programs, and projects.
• The Project Manager is a critical team member responsible for driving and coordinating multiple cross-functional work streams to deliver results on key initiatives, to improve critical business processes, and to achieve strategic objectives with a sense of urgency.
• Facilitates coordination of all elements which support project work (meetings, agendas, deliverables, etc.).
• Maintains/updated schedules and calendars.
• Provides logistical support as needed.
• Establishes project plans, RAID logs, reporting dashboards, and status reporting.
• Maintains effectiveness when experiencing major changes in work responsibilities or environment; adjusts effectively to work within new work structures, processes, requirements, or cultures as a part of a geographically distributed team.
• Plans, directs, and coordinates activities of designated project(s) to ensure that goals or objectives of the project are accomplished within prescribed time frame and funding parameters.
• Alters plans and makes recommendations for future project phases or future projects, based on lessons learned from the project.
• Prepares project reports for management, client, or regulatory agencies as required.
• Communicates project initiatives and tasks to team members and committee members clearly and regularly.
• Confers with staff to outline work plan and to assign duties, responsibilities, and scope of authority.
• Responds to feedback and status reports from the project team and applicable committees/leadership to revise the project tasks and/or timeline as necessary.
• Provides guidance and positive models to help others develop; seeks suggestions for improving performance; collaboratively creates development plans that include activities targeted to specific goals; leverages environmental supports and removes development barriers; advocates for individual to higher levels of management to create development opportunities.
• Remains informed of changing applicable regulations which may affect project objectives, goals, progress and/or timelines. Alter project plan accordingly.
• Travel to company subsidiaries is required.
• Performs all other duties as assigned.

• Manage all aspects of a project for cross-functional teams
• Management of major implementation initiatives, programs, and projects
• Drive and coordinate multiple cross-functional work streams to deliver results on key initiatives
• Improve critical business processes and achieve strategic objectives with a sense of urgency
• Facilitate coordination of all elements which support project work (meetings, agendas, deliverables, etc.)
• Maintain/updated schedules and calendars and provide logistical support as needed
• Establish project plans, RAID logs, reporting dashboards, and status reporting
• Plan, direct, and coordinate activities of designated project(s) to ensure goals/objectives are accomplished within prescribed time frame and funding parameters
• Prepare project reports for management, client, or regulatory agencies as required
• Communicate project initiatives and tasks to team members and committee members clearly and regularly
• Confer with staff to outline work plan and to assign duties, responsibilities, and scope of authority
• Respond to feedback and status reports from the project team and applicable committees/leadership to revise project tasks and/or timeline as necessary
• Provide guidance and positive models to help others develop; create development plans and advocate for individuals to higher management
• Remain informed of changing applicable regulations and alter project plan accordingly
• Travel to company subsidiaries is required
• Perform all other duties as assigned

Accounts Receivable

• Assure that accounts have been properly billed and reimbursed to contribute to financial viability
• Contact insurance companies to secure and expedite payments through follow-up and appeals resolution processes
• Act as a functional leader or reference source and provide the communication link between CHS, patients, payers, and providers
• Follow up on required daily accounts based on leadership assignments to reduce the A/R
• Validate denied claims and determine appropriate denial resolution, including authorization/retro authorization/precertification
• Utilize WAYSTAR to submit appeal letters and payer-required documentation on unpaid and underpaid claims
• Document action taken toward account resolution within Avatar and WAYSTAR using standardized note format
• Prioritize work to increase efficiency in the collections process and meet departmental productivity requirements
• Communicate identified opportunities with leadership utilizing SBAR format and follow chain of command
• Participate in coordinated departmental initiatives related to AR reduction and troubleshoot technological issues
• Assist billing with determining disposition of or composing replies to incoming mail and other correspondence
• Perform all other duties as assigned

Accounts Receivable Resolution Specialist

• Manage all aspects of projects for cross-functional teams, including major implementation initiatives, programs, and projects
• Drive and coordinate multiple cross-functional work streams to deliver results, improve business processes, and achieve strategic objectives
• Facilitate coordination of project elements (meetings, agendas, deliverables), maintain/update schedules and calendars, and provide logistical support
• Establish project plans, RAID logs, reporting dashboards, and status reporting
• Plan, direct, and coordinate activities to ensure project goals/objectives are accomplished within time frames and funding parameters
• Prepare project reports for management, clients, or regulatory agencies as required
• Communicate project initiatives and tasks to team members and committees; assign duties and scope of authority
• Respond to feedback and revise project tasks/timelines as necessary; alter plans and recommend future project phases based on lessons learned
• Provide guidance and development support to team members; advocate for development opportunities with management
• Remain informed of changing applicable regulations and alter project plans accordingly
• Travel to company subsidiaries as required; perform other duties as assigned

• Contact the appropriate insurance company to secure and expedite payments through follow-up and appeals resolution processes
• Follow up on required daily accounts based on leadership assignments to reduce the A/R
• Perform timely and accurate validation of denied claims and determine appropriate denial resolution, including authorization/retro authorization/precertification
• Utilize WAYSTAR to submit appeal letters and payer-required documentation on unpaid and underpaid claims
• Document action taken toward account resolution within Avatar and WAYSTAR using standardized note format
• Prioritize work to increase efficiency in the collections process and meet productivity requirements
• Effectively communicate identified opportunities with leadership utilizing SBAR format and follow chain of command
• Participate in coordinated departmental initiatives related to AR reduction and assist billing with incoming mail and correspondence
• Troubleshoot technological issues and communicate to leadership; perform other duties as assigned

• Manage all aspects of a project for cross-functional teams, including major implementation initiatives, programs, and projects
• Drive and coordinate multiple cross-functional work streams to deliver results on key initiatives and improve critical business processes
• Manage priorities, projects, and stakeholders to ensure on-time and on-budget delivery of solutions
• Facilitate coordination of project elements (meetings, agendas, deliverables) and provide logistical support
• Maintain and update schedules and calendars; establish project plans, RAID logs, reporting dashboards, and status reporting
• Plan, direct, and coordinate project activities to ensure goals are accomplished within timeframes and funding parameters
• Prepare project reports for management, clients, or regulatory agencies as required
• Communicate project initiatives and tasks clearly and regularly to team members and committees
• Assign duties, responsibilities, and scope of authority; respond to feedback and revise project tasks/timelines as necessary
• Provide guidance and development to team members and advocate for development opportunities
• Remain informed of changing applicable regulations and alter project plans accordingly
• Travel to company subsidiaries as required; perform other duties as assigned

• The AR Resolution Specialist contributes to the financial viability of the organization by assuring that accounts have been properly billed and reimbursed.
• Contacting the appropriate insurance company to secure and expedite payments through the follow-up and appeals resolution processes and acting as a functional leader or reference source.
• This position requires discretion and good judgment in decision-making and representation of Connections Healthcare Solutions.
• Work situations are varied and require extensive insurance billing, follow-up and appeal knowledge, and strong customer service skills.
• This position provides the link in communication between Connections Healthcare Solutions and the patient, insurance companies/third-party payers, and the provider of service or departmental staff.
• The AR Resolution Specialist performs these functions at a complex level of implementation, analysis, and resolution.
• Follows up on required daily accounts based on leadership assignments to reduce the A/R.
• Performs timely and accurate validation of denied claims and determines appropriate denial resolution, including but not limited to; authorization/retro authorization/precertification.
• Utilizes WAYSTAR to submit appeal letters and payer-required documentation on unpaid and underpaid claims.
• Prioritizes work to increase efficiency in the collections process.
• Documents action taken toward account resolution within Avatar and WAYSTAR using standardized note format.
• Meets productivity requirements as set within the department.
• Effectively communicates identified opportunities with leadership utilizing SBAR format.
• Follows chain of command as defined through CHS leadership.
• Participates in coordinated departmental initiatives related to AR reduction.
• Takes initiative to troubleshoot technological issues and communicates to leadership according to department guidelines.
• Assists billing with determining the proper disposition of or composing replies to incoming mail and other correspondence.
• Performs all other duties as assigned.

• Manage all aspects of a project for cross-functional teams
• Manage major implementation initiatives, programs, and projects
• Drive and coordinate multiple cross-functional work streams to deliver results on key initiatives
• Facilitate coordination of all elements which support project work (meetings, agendas, deliverables, etc.)
• Maintain/update schedules and calendars and provide logistical support as needed
• Establish project plans, RAID logs, reporting dashboards, and status reporting
• Plan, direct, and coordinate activities of designated project(s) to ensure goals are accomplished within time frame and funding parameters
• Alter plans and make recommendations for future project phases based on lessons learned
• Prepare project reports for management, client, or regulatory agencies as required
• Communicate project initiatives and tasks to team members and committee members clearly and regularly
• Confer with staff to outline work plan and to assign duties, responsibilities, and scope of authority
• Respond to feedback and status reports to revise project tasks and/or timeline as necessary
• Provide guidance and development to team members and advocate for development opportunities
• Remain informed of changing applicable regulations and alter project plans accordingly
• Travel to company subsidiaries as required
• Perform all other duties as assigned

• Manage all aspects of a project for cross-functional teams
• Management of major implementation initiatives, programs, and projects to improve critical business processes and achieve strategic objectives
• Drive and coordinate multiple cross-functional work streams to deliver results on key initiatives and ensure on time and on budget delivery of solutions
• Facilitate coordination of all elements which support project work (meetings, agendas, deliverables, etc.); provide logistical support as needed
• Maintain/updated schedules and calendars; establish project plans, RAID logs, reporting dashboards, and status reporting
• Plan, direct, and coordinate activities of designated project(s); alter plans and make recommendations for future project phases based on lessons learned
• Prepare project reports for management, client, or regulatory agencies as required
• Communicate project initiatives and tasks to team members and committee members clearly and regularly; confer with staff to outline work plan and assign duties
• Respond to feedback and status reports from the project team and applicable committees/leadership to revise project tasks and/or timeline as necessary
• Provide guidance and positive models to help others develop; create development plans and advocate for individuals to higher management
• Remain informed of changing applicable regulations which may affect project objectives and alter project plan accordingly
• Travel to company subsidiaries is required; perform all other duties as assigned