Trillium Health Resources

Manager

• Provide Tailored Care Management.
• Educate individuals/families on details surrounding the Registry of Unmet Needs (RUN) and offer available resources for services, supplies/equipment.
• Complete assessments and care planning activities with members and their treatment team.
• Coordinate with the member and their care team to refer and link the member to needed services and supports.

Waitlist Care Manager

• Provide direct supervision and support to QP level coordinators, licensed clinicians and certified peer support specialists.
• Monitor team’s quality of work and take corrective action as needed.
• Oversee complex cases ensuring sound decision making and wholistic client care.
• Support staff to effectively plan and coordinate member transitions from incarceration to the community.
• Collect data, assign cases, and conduct quality audits.
• Collaborate with internal departments and external systems including prisons/jails, probation/parole, BH/SU providers, and other stakeholders.

Support Transition and Reentry Manager

General

• Serve as a point of contact on Hospital/ED calls to assist with discharge planning and coordination of care needs following an ED/inpatient admission
• Provide short-term care coordination on a case-by-case basis, which may include working with management to remove barriers to expedite ED discharge; for members who are inpatient, safe and timely discharge will be facilitated by providing viable and appropriate recommendations
• Link and/or refer members, guardians, hospital/ED staff and stakeholders to various services, providers or community resources specific to the population being served
• Participate on various cross-functional projects or tasks
• Review and maintain data, information, and documentation
• Work collaboratively with internal departments to identify, communicate and track needed services, providers, and resources

Discharge Planning Coordinator

• Engage members in the care coordination/care management process.
• Provide education about all available services, natural and community supports, treatment options, diagnosis, etc.
• Provide linkage to needed psychological, behavioral, educational, physical, and dental evaluations.
• Facilitate referrals for health-related services, community-based resources and social support services, and community reintegration supports.
• Evaluate the outcome of the care plan and reintegration supports.

State Hospital Care Manager

Learning and Development

• Coordinate the ongoing development of training and development programs in support of assigned areas.
• Develop training plans for individuals and groups utilizing best practices and identify training outcomes while evaluating their achievement.
• Monitor all training development coordination-related activities to ensure alignment with program goals.
• Engage and collaborate with leadership to identify immediate and ongoing training and development needs and communicate training plans effectively.
• Develop assessment tools for the training and development program, as well as individual outcomes assessment.
• Coordinate and ensure that designated staff members receive required/mandatory trainings.

Training & CWCN Workforce Development Coordinator

• Perform supportive outreach, follow-up, and engagement with members.
• Facilitate programs and activities that promote holistic health and improve members’ health literacy/education (teaching self-management skills, sharing self-help recovery resources, distributing educational materials on chronic conditions, etc.
• Arrange/schedule various member services, including appointments, wellness reminders, and non-emergency medical transportation needs.
• Collaborate with the Care Manager and other personnel of the care team to communicate information regarding the members’ care, including health updates and changes.
• Participate in relevant educational case conferences.
• Ensure the proper storage and transmission of sensitive health records.

Regional Health Specialist

• Engage identified member into applicable Care Management program and utilizes data and information from multiple sources to address member’s needs to make clinical decisions.
• Identify Trillium members appropriate for population health programs; Working with Care Management and external partners to enroll and engage members by identifying mission/goals and objectives of the program along with assisting in completing a thorough clinical background.
• Work collaboratively with members of the multidisciplinary team to develop tools and interventions designed to achieve optimal patient outcomes.
• Coordinate and facilitate with Care Management staff and/or external partners timely implementation of assessments, care plans, and appropriate interventions for identified member populations following established policies and procedures.
• Use a collaborative approach to assist the member with self-management goals and identifying barriers by addressing the total individual.

Clinician

Data Analyst

• Manage Trillium Health Resources Medical Economics MLR and IBNR reporting and ensure compliance with related regulations, standards, and policies.
• Work with the Director of Medical Economics to model the financial impacts of policy changes and clinical decisions.
• Develop and promote best practices and drive innovation through various types of data.
• Oversee the development of Medical Economics reporting and participate in various organization-wide process improvement initiatives.
• Provide direct supervision to analytics staff, including conducting performance evaluations, coordinating training, and implementing hiring, discipline and termination procedures.

Medical Economics Analytics Manager

Financial Planning and Analysis

• Lead enterprise financial strategy and oversee Finance and Medical Economics functions
• Direct financial operations, including accounting, reporting, audits, and budgeting
• Partner with executive leadership to develop and implement financial initiatives
• Analyze financial performance to inform strategic and operational decision-making
• Monitor market trends, including managed care and value-based care developments
• Lead development and performance management of finance leadership staff

Chief Financial Officer, CFO

• Utilize person centered planning methods and strategies to gather information, to get to know the members supported and to adequately address specific needs of the individual.
• Provide education and support to members on learning about and exercising rights and responsibilities.
• Complete discovery activities (information gathering and assessment) as a component of the planning process.
• Ensure that assessments and plans are updated as needed and whenever the member’s life circumstances change.

IDD Care Manager

• Oversee and manage Trillium’s provider appeals processes.
• Supervise provider appeals staff and evaluate the effectiveness/efficiency of the department through regularly scheduled individual staff supervision and staff meetings.
• Interface with vendors and internal business units to ensure compliance and good communication across the department.
• Research, read and interpret controlling authority (coverage policies and service definitions, State and federal statutes and regulations, applicable contracts, agency policies & procedures, etc.).
• Oversee accurate and complete files for each appeal with all documents used in decision making.
• Prepare files for audits and reviews, including, but not limited to, external quality reviews and accreditation reviews.
• Support staff in drafting appeal resolution letters in accordance with practices established by the Legal Department and ensure all appeals are processed and completed timely within accordance with legal and contractual and accreditation standards.
• Prepare reports for internal and external stakeholders.

Appeals Manager

Operations

• Developing policies, procedures, practices, and systems that support the provision of care management services
• Demonstrating clinical expertise for specific complex and/or rising risk member populations
• Identifying members that are appropriate for population health programs utilizing data informatics
• Providing interventions and education to promote health prevention and promotion
• Managing, reviewing, and analyzing operations and services provided for adherence to program goals and objectives
• Collaborating with internal teams to identify gaps or opportunities for improved workflows or process changes for special populations
• Serving as a subject matter expert regarding identified special populations, regulatory requirements, policies, procedures, programs and staff support; provide staff education and training on relevant program components
• Overseeing utilization of resources used by specialty population

Population Health Operations Clinical Oversight Clinician

• Provides analysis within the Finance Department of payments made for professional contracts with vendors, non-UCR contracts with providers, and purchase orders
• Apply principles of accounting to analyze financial information and prepare financial reports by compiling information and utilizing appropriate accounting control procedures
• Responsible for timely and appropriate payments to vendors and providers by ensuring the accuracy of expenditures through the review and interpretation of contract terms.
• Review expenditures to ensure that they are complete and timely.
• Review monthly provider/vendor invoices and supporting documentation for accuracy, completeness, and compliance.
• Work with the Financial Operations Team on assignments, tasks, and guiding the workflow.
• Review processes and procedures to ensure they are operating effectively and efficiently.
• Preparation of monthly journal entries as needed.
• Review, investigate, and correct errors in payables entries, documents, and reports.

Senior Financial Operations Associate

Network Engineer

• Administer, maintain and support the Agency’s data, voice & security systems infrastructure, including the Wide Area Network (WAN), Local Area Network (LAN), all servers, PCs, switches, routers, printers and miscellaneous peripheral equipment; make recommendations for future hardware or software additions or enhancements.
• Maximize network performance by monitoring performance; troubleshooting network problems and outages; scheduling upgrades; collaborating with network architects on network optimization.
• Secure network systems by establishing and enforcing policies, defining and monitoring access.
• Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
• Report network operational status by gathering, prioritizing information, managing projects.
• Monitor problem/change activities and coordinates involvement of technical and staff and vendors to ensure effective implementation of new or enhanced systems and resolution of user problems.

IT Network Engineer

Systems Engineer

• Design, build, test, deploy, document, and maintain Power BI reporting solutions and semantic models, including the SQL queries, data pipelines, and dependent systems that power them—continuously assessing platform capabilities, performance, and governance.
• Work with IT Leadership, Informatics - Data Management, IT Operations and IT - Business Systems on researching, developing, testing, deploying and documenting new methods and tools for ingestion, processing, sending and sharing of data.
• Plan, coordinate and implement security measures (including regular audits) to safeguard information in reporting platforms and computer files against accidental or unauthorized damage, modification or disclosure.
• Specify users and user access levels for each segment of the reporting platforms, as needed.
• Select, develop and deploy code to monitor reporting platform performance
• Develop reference and workflow documents for documentation purposes.
• Revise agency definition of data as defined in data dictionary in regards to reporting and visualizations.