Trinity Health

Human Resources

• Supervise and support a hybrid team performing Tier 2 benefits operations
• Provide coaching, work prioritization, and performance oversight
• Handle complex case escalations from Tier 1 or other business units
• Establish and maintain collaborative relationships with cross-functional teams
• Review and approve team timecards in alignment with organizational policies
• Monitor attendance patterns to ensure compliance
• Work with the manager to provide team analytics and maintain metrics
• Utilize presentation skills for updates to management
• Identify skill development & training needs for the team
• Manage the administration and reconciliation of benefits programs
• Handle complex and escalated cases, adjudicating appeals
• Collaborate with Total Rewards Benefits and Legal Department
• Reconcile benefit discrepancies related to pay, and coverage issues
• Include OE execution, task planning, assignment, and appeals processing
• Lead and partner on activities related to annual Open Enrollment
• Conduct audits and root cause analysis for system improvements
• Ensure integrity and effectiveness of Tier 0 knowledge resources
• Prioritize the Colleague Experience and maintain strict confidentiality

Supervisor, HRSS Operations – Tier 2 Benefits Administration

Insurance

• Receive and confirm insurance related information and coverage from patient referrals for the Metabolic and Bariatric Surgery program
• Determine necessity for pre-authorization and obtain authorization for scheduled procedures
• Enter patient insurance information into the patient record (Epic) and document insurance coverage of services to be provided
• Notify patient of his/her financial responsibility for services to be provided
• Notify patients and practitioners of any services requested and/or referred that are not authorized by insurance
• Communicate with patients and practitioners regarding financial responsibility and insurance coverage issues
• May work with projects that are insurance and prior authorization related

Bariatric Program Insurance Representative – Full-Time

• responsible for acting as an insurance advisor at MercyOne
• assist with insurance verification
• manage accounts receivable and billing

Insurance Advisor

Manager

• Oversees delivery of effective Spiritual Care services
• Manages and coaches chaplains across the continuum of care
• Provides direct service as a chaplain
• Collaborates with the Director of Spiritual Care for talent development
• Assists in accessing necessary resources for implementation of priorities
• Models effective chaplain skills in providing services
• Promotes use of Trinity Health Leadership System in planning and implementing activities
• Oversees standard best practices for Spiritual Care assessments and interventions

Manager, Spiritual Care

Call Center Representative

• Supervises daily functions of assigned area(s)
• Provides clear direction & manages / advances people, processes, structures & / or programs that support direct / indirect care
• Works in collaboration with department managers to manage staff & department effectively
• Responds promptly & directly to meet or exceed customers’ needs
• Coordinates staff scheduling & assignment
• Reviews & approves administrative functions (time, payroll, expense)

Supervisor, Human Resources Shared Services – Tier 1 Contact Center Operations & Case Management

Medical writer

• Utilizes advanced clinical and coding expertise to direct efforts toward the integrity of clinical documentation through the roles of reviewer, educator and consultant.
• Facilitates the overall quality, completeness, accuracy and integrity of medical record documentation through extensive record review.
• Achieves appropriate clinical documentation to support code assignment, medical necessity, severity of illness, risk of mortality and level of services rendered to all patients.
• Participates in the development and delivery of education for providers and members of the healthcare team.
• Demonstrates understanding of appropriate clinical documentation to ensure that the severity of illness, risk of mortality, quality indicators and level of services provided are accurately reflected in the health record.

Clinical Documentation Specialist – CDI

Therapist

• Join the MercyOne Team as a full-time Occupational Therapist
• Evaluate and treat a diverse population
• Develop treatment plans with involvement in family/support systems
• Work with other professionals (Physicians, SLPs, PTs and other OTs) in an outpatient setting

Occupational Therapist

Auditor

• Provide safe, quality health care services & assistance to patients
• Perform clinical care activities for patients within the scope of practice
• Maintain a working knowledge of applicable laws/regulations
• Advocate for patients and inform/counsel patients & families about illness & care details
• Collaborate with interdisciplinary team to improve outcomes

Nurse Auditor, Revenue Integrity

• Oversee daily utilization review operations, serving as first point of escalation for issue resolution.
• Ensure compliance with payer and regulatory requirements.
• Provide supervisory leadership through scheduling, performance management, and guiding staff development.
• Direct utilization review workflows and medical necessity evaluations.
• Manage denial prevention, expedited appeals, and payer communication to secure authorizations.
• Collaborate closely with Physician Advisors, CRM Managers, and the multidisciplinary team to maintain reporting and optimize departmental processes.

Nurse Manager, Utilization Review

• Focus on customer excellence through rapport building and establishing trust
• Administers HR policies and procedures
• Investigates and resolves HR related issues via telephone and e-mail
• Provides prompt solutions to inquiries
• Performs HR administration and benefits transactions in Workday
• Processes employment verifications and requests for employment status
• Collaborates with other HR Service Center team members
• Maintains confidentiality of department and associate information

HR Rep I

• Provides assistance to managers and vendors in onboarding processes
• Supports payroll processing and HR policies
• Maintains confidentiality and compliance with laws and guidelines

Senior HR Rep

• Deliver one-on-one, high-quality care to patients in the comfort of their homes.
• Assess, plan, and manage individualized care that promotes healing and independence.
• Case manage a team of 15-20 hospice patients.
• Collaborate with interdisciplinary team and attend weekly Interdisciplinary meetings.
• Interact with the primary care physician and/or hospice medical director as needed.
• Make appropriate referrals for evaluation/care to other disciplines and services.

Hospice Registered Nurse Case Manager, RN

• Provides Human Resource (HR) support for various operations and services
• Interacts with executives and various levels of management
• Completes actions pertaining to HR operational policies
• Reviews and processes HR transactions
• Assists with HR related communications and continuous improvement of HR practices

Human Resource Specialist

Analyst

• Conducts prospective analysis of the potential financial impact on the member organizations of major changes in Medicare and Medicaid policies.
• Assists in related advocacy efforts regarding such regulatory changes.
• Monitors policies and procedures to ensure reimbursement practices adhere to federal, state and other third-party reimbursement regulations.
• Prepares Annual Medicare, Medicaid, Blue Cross and Tricare cost reporting for the Trinity Health Corporate Office and Trinity Information Systems.
• Prepares quarterly Medicaid reporting schedules.
• Prepares Rolling Forecasts and Annual Budgets.
• Participates in the Medicare, Medicaid and Blue Cross audits of Trinity Health Corporate Office, Trinity Information Systems, and the various insurance programs with focus on Graduate Medical Education, Disproportionate Share, Bad Debt and the S-10.
• Analyzes tentative and final settlements.
• Coordinates, researches and analyzes prior year reopening and appeals.
• Prepares financial month end close reporting for Net Revenue.
• Responsibilities include, but are not limited to, accessing databases, and utilizing reporting tools to extract data, generate reports, perform data analysis, and draft system/process improvement recommendations.
• Prepares analyses and interprets highly complex reimbursement issues.
• Prepares complex financial models and analyses to assure proper reimbursement.
• Participates in third-party payer preparing impact analysis and recommendations.
• Participates in developing and monitoring appeals with third party payers.
• Provides analytical reimbursement support, consulting, and education to the corporate office and member organizations.
• Reviews and analyzes member organization third party reserves and net revenue/contractual calculations.
• Conducts analysis related to revenue improvement initiatives.
• Prepares project analysis regarding operational issues, new programs, service lines, expansions, etc.
• Serves as a subject matter expert and resource by providing guidance and problem resolution to internal associates on matters impacting projects and day-to-day assignments.
• Maintains a working knowledge of applicable Federal, State and local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
• Performs other duties as assigned.

Senior Reimbursement Analyst

Operations

• Implement, support, and maintain the mission of St. Joseph’s Physicians, delivering quality healthcare
• Oversee functions and operations of clinical services for offices within the employed Medical Group
• Develop and implement standardized clinical workflows, policies, procedures, and standards of care
• Oversee clinical orientation, development, and education with respect to nursing roles
• Coordinate with administration and practice managers to maintain quality standards
• Collect, analyze, and report recruitment and retention information; implement methods for improvement
• Support medical group and system leadership in initiatives across the network