Trinity Health

Administration

• Supervises daily functions of assigned department
• Manages and advances people, processes, structures & programs for direct/indirect care
• Responsible for daily operations & oversight of staff
• Coordinates staff scheduling & assignment
• Provides clear direction and implements departmental plans
• Functions as an operational leader within the HR Service Center

Supervisor, Case Management, Leave of Absence Administration

• Supervises daily functions of assigned department
• Provides clear direction & manages / advances people, processes, structures & / or programs that support direct / indirect care
• Implements departmental plans & priorities identified by accountable leaders
• Reviews & approves administrative functions (time, payroll, expense)
• Maintains a working knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct
• Oversees & supports the implementation of leave-related policies, procedures & technologies

Supervisor, Timekeeping, Leave of Absence Administration

Manager

• Responsible for the clinical and operational elements of the homecare program
• Achieve identified targets and metrics of clinical outcomes
• Ensure productivity, visits/episode, overtime, employee engagement/retention, budget targets

Home Care Clinical Manager

• Provides oversight and support of leave administration workflows
• Develops and improves policies and procedures
• Communicates goals and standards effectively
• Collaborates with leadership for operational efficiency

Leave Specialist, Leave of Absence Administration

Auditor

• Responsible for coding and abstracting patients’ records for professional billing
• Reviews patient medical records retrospectively and concurrently for the coding and sequencing of diagnoses and procedures for reimbursement purposes
• Interacts and assists with coding requests and questions from billers
• Serves as a resource for difficult coding questions and assists with insurance denials for correction and re-filing
• Makes process improvement recommendations to management as identified, specifically related to registration and charge posting
• Performs in compliance with federal, state, insurance industry regulations

Auditor Coding Specialist

Therapist

• Evaluate and treat patients needing OT services in the home in the Waterbury (Team 5) Region
• Attend regular team meetings and coordinate care with other disciplines
• Effectively and efficiently prioritizes visit content and plans visits based on client
• Maintains a working knowledge of applicable Federal, State and local laws and regulations, the Organizational Integrity Program, Code of Ethics, as well as agency policies and procedures and adheres in a manner that reflects honest, ethical and professional behavior
• Accurately assesses clients at admission, at required time points, and as needed, utilizing appropriate standardized documentation
• Assesses the client’s condition and needs and determines the agency’s ability to meet those needs in the home care setting
• Develops appropriate assessment-based plan of treatment with physician and client
• Plan includes attainable episode goals and agency services needed to improve and/or stabilize client’s medical condition and promote independence
• Participates in timely revision of the plan of treatment as appropriate
• Makes appropriate referrals for evaluation/care to other disciplines and services, and coordinates care with others to ensure effective and efficient care is provided
• Utilizes interview, observation and evaluation in assessing clients and applies professional judgment, consistent with practice standards, in formulating interventions and making recommendations to the physician and client
• Evaluates the home environment and makes recommendations for the establishment of effective household management
• Initiates and implements appropriate preventive, therapeutic and rehabilitative procedures and techniques in accordance with the plan of treatment
• Assists and instructs client and family members in activities and concepts to promote the client’s health, safety, and independent function

Home Care Occupational Therapist

Customer Support

• Support the HCCs with referral entry and referral insurance verification
• Act as data entry support
• Responsible for accepting, importing and entering referrals from our RHMs into Home Care Home Base
• Responsible for the insurance verification and authorization for certain payers

Referral Support Specialist

Consultant

• Provides leadership, direction & oversight of one or more national Trinity Health and/or HR service area wide program(s) or workstreams.
• Consults predominantly with ministry level directors & above & service partners to identify OE programs & services to meet client needs.
• Develops & manages aligned program(s) project, production, communications, and/or service delivery plans & workflows to ensure plans are successfully implemented & services are delivered on time, on budget & to specifications.
• Maintains a working knowledge of applicable Federal, state & local laws/regulations, Trinity Health Integrity & Compliance Program & Code of conduct.

Organization Effectiveness Consultant

Medical Director

• Provide clinical leadership and oversight of all owned PACE programs
• Collaborate with a variety of system-level leaders in the departments of Finance, Quality, Compliance, Informatics, Coding, Claims adjudication, Education, Credentialing and Operations
• Create and maintain an atmosphere of warmth, propagating a calm environment throughout the office
• Promote and maintain collaborative relationships with managers, peers, direct reports and customers
• Coordinate communication with Pharmacy Benefit Manager and pharmacy provider(s) as necessary
• Participate in Part D audits and development of corrective action plans
• Establish expectations for Utilization Management meetings

Chief Medical Officer, CMO – PACE

Clinical Operations

• Responsible for the overall planning, coordination, implementation, execution, and completion of medium and large projects and tasks, ensuring consistency with organization strategy, commitment to goals, and enhancing the functions of the team.
• Serves as project manager to ensure on-time completion of initiatives, aids with communication, tracks measures of success and creates new methods to improve processes; Maintains records of meeting notes and action items during committee meetings and follows up with outstanding items to bring to completion.
• Works closely with the senior team and other members of leadership and frontline colleagues to meet project timelines.
• Prioritizing work to ensure the delivery of high-quality service to our patients, colleagues, providers, and communities.
• Utilizes project management tools, documentation and reporting applications and tracking systems to maintain current project plans, actions, due dates, dependencies, workflow, notifications and data.
• Utilize Lean/Six Sigma principles, methods, and tools to identify areas for time and cost savings; participates and leads improvement projects; and implements solutions.
• Accountable for successfully managing project outcomes, anticipating needs and deadlines, and providing practical solutions for execution.
• Responsible for obtaining and analyzing data to prepare reports and to communicate and identify solutions in support of organizational strategy and objectives.
• Provides just in time project management training for established project management teams in order to facilitate team knowledge and capability to perform the required work and achieve the required objectives necessary for project completion.
• Prepares and conducts education in project management and lean principles for senior leaders, managers and colleagues to elevate overall organizational performance in the recognition of potential projects, use of project management concepts, development of project management skills, and capability for defining potential projects for development within individual departments and among interdepartmental/ interdisciplinary teams.

Project Manager – Clinical Operations

• Manages, directs and provides leadership and strategic oversight of the Regional Professional Coding team
• Partners with auditing, billing, finance, and operations to promote coding accuracy
• Ensures systems and processes comply with federal, state and payer-specific coding, billing and reimbursement guidelines
• Oversees coding and charge capture reconciliation with Regional Professional Coding Supervisor(s)
• Monitors daily trends to help guide Revenue Site Operations leadership team with targeted areas for improvement.

Regional Manager, Professional Coding

Analyst

• Responsible for the data capture, analysis & reporting of data information to assist the Trinity Health leadership team achieve operational efficiency.
• Responsible for auditing of department information, producing reports & suggesting improvements to processes.
• Provides knowledge & expertise in the program, services & applications.
• Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience.
• Responsible for distribution of analytical reports.
• Utilizes multiple system applications to perform analysis, create reports & develop educational materials.
• Incorporates basic knowledge of Trinity Health policies, practices & processes to ensure quality, confidentiality & safety are prioritized.
• Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge.
• Research & compiles information to support ad-hoc operational projects & initiatives. Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making.
• Leverages program & operational data & measurements to define & demonstrate progress, ROI & impacts.
• Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.
• Responsible for ensuring accurate CPT and/or ICD-10 documentation for the patient billing process and educating colleagues and providers in accurately document services performed and using the appropriate codes representing those services.
• Maintains documentation regarding charge capture processes. Performs regular reviews of process adherence and identify missing charges. Coordinates with key stakeholders regarding impacts of system change requests and upgrades to processes to ensure capture accuracy. Provides oversight of charge reconciliation processes for assigned departments; ensuring daily and appropriate monthly reconciliations are occurring.
• May perform or provide “at elbow” guidance to clinical departmental daily reconciliation processes including ensuring supply charges are appropriate captured (may include implants), identify duplicate charges and initiate appropriate communications when there are documentation and/or charge deficiencies or charge errors. Performs charge entry/capture functions, charge approvals, and/or quality charge reviews; including but not limited to, appending modifiers, and checking clinical documentation. Provides feedback to intra-departmental Revenue Integrity colleagues including areas of opportunity. Reviews and responds to various quality reports, including reports that identify missing charges, duplicate charges, late charges, etc. Maintain and update required reference logs and other reporting tools. May create and present information for decision making purposes. Supports other stakeholders with denial related charge reviews including analysis of clinical documentation, root cause analysis and education to the responsible ancillary department.

Revenue Integrity Charge Analyst

Director

• Provide executive-level, transformational leadership for the strategic planning, integration, financial performance, and clinical evolution of multiple service lines across the entire care continuum.
• Drive strategic growth, operational excellence, quality improvement, and clinical integration across inpatient, procedural, and ambulatory settings.
• Partner with the Medical Directors to align the service line’s goals with health system priorities and advance its reputation as a center of excellence.
• Develop, implement, and govern multi-year strategic and business plans including aggressive Key Performance Indicators (KPIs) and measurable milestones.
• Facilitate and lead the service line's executive governance structure, ensuring clear accountability and initiative implementation through Performance Excellence practices.
• Coordinate clinical standardization across care settings and facilities to support evidence-based practice and care continuity.

Director of Clinical Service Line Strategy

Business Analyst

• Provides specialized technical and analytical support for an operational area of revenue management.
• Work assignments are complex and responsible requiring a depth of knowledge in an area of specialization.
• Conducts impact analyses and modeling, assesses trends, develops projections, and prepares detailed written summaries for management review.
• Participates in defining project plans and goals; manages and/or leads small projects or portions of projects.
• Designs, develops, implements, and maintains systems that provide financial, statistical, and operational information.

Senior Revenue Management Analyst – Reimbursement Analyst, Medicare

Bilingual

• Provide in-home skilled nursing care to patients by developing personalized care plans, administering medications and supporting recovery and independence.
• Follows orders for treatment and provides services as indicated on the plan of care.
• Utilizes and implements appropriate educational tools and pathways per guidelines and/or policy and procedure.
• Takes ownership to optimize agency performance through active involvement in quality improvement activities.
• Provides ongoing care management oversight/activities to assigned patients to achieve high quality care, reduced rehospitalizations and achievement of top decile outcomes.
• Utilizes motivational interviewing/health coaching techniques to achieve desired patient outcomes.
• Adjusts weekly, monthly patient visit schedule to achieve care consistency, visit utilization ordered and operational efficiencies, avoiding duplication, interruption or overlap in visits.
• Initiates, maintains, and documents communication regarding the client’s care/needs with the physician, clinical manager, other disciplines, and family, as appropriate.
• Acts independently and responsibly to perform duties on a consistent basis and in a timely manner.