Trinity Health

Patient Access

• Researches, collects & analyzes information.
• Identifies opportunities, develops solutions, & leads through resolution.
• Collaborates on performance improvement activities.
• Responsible for distribution of analytical reports.
• Utilizes multiple system applications to perform analysis, create reports & develop educational materials.
• Maintains a working knowledge of applicable federal, state & local laws / regulations.
• Research & compiles information to support ad-hoc operational projects & initiatives.
• Synthesizes & analyzes data & provides detailed summaries.

Patient Access Representative I – 2nd Shift

General

• Portrayal of all signs, symptoms, physical findings, behavior, and emotional states of a given patient case.
• Portrayal of other simulation participant roles, such as family members and patient advocates.
• Accurate and efficient completion of checklists and rating forms.
• Demonstrate flexibility, reliability, and punctuality relative to assigned cases.
• Be willing to be examined multiple times with repeated physical examination maneuvers while wearing a hospital gown over undergarments.
• Be willing to be audio and videotaped and/or observed live through observation window or video monitor.
• Maintain security and confidentiality of all video-taped proceedings in accordance with center and hospital policy.
• Maintain confidentiality of all student, associate, and/or hospital information as required.
• Maintain order, cleanliness and safety of all work areas.
• Interact in a professional manner with all learners, faculty, fellow SPs, and staff.
• Provide constructive feedback to case participants.
• Employ improvisational skills as cases warrant.
• Assimilate ongoing feedback from facilitators/instructors regarding performance.
• Accept feedback and alter portrayal accordingly.
• Follow written and verbal instruction.

Standardized Patient

Nurse Navigator

• Manages the case load of patients and identifies new patient candidates
• Communicates with management on operational and patient issues
• Improves health care access and promotes client compliance
• Assists with needed referrals for testing and treatment
• Educates care team and patients in medical management
• Participates in the development and evaluation of care paths

Registered Nurse Navigator – Surgical Services

Procurement

• Responsible for data capture, analysis & reporting to assist Trinity Health leadership in achieving operational efficiency
• Audits department information, produces reports & suggests improvements
• Collaborates on performance improvement activities
• Utilizes multiple system applications for analysis, report creation & educational materials
• Maintains working knowledge of applicable laws & regulations
• Collects and validates large datasets for accuracy
• Develops dashboards, reports, and visualizations using tools like Power BI, Tableau, or Excel
• Supports competitive bidding processes and contract optimization opportunities

Strategic Sourcing Analyst – Technology Sourcing

• Develops, monitors, inspects & proposes measures to correct and improve hospital registration performance.
• Tracks and reports trends to remediate issues and assist with preventive actions for ongoing internal process improvement.
• Leverages patient access and revenue cycle knowledge to ensure continuous quality improvement.
• Conducts facility analysis of denials.
• Prepares and submits review findings, makes recommendations, and works closely with interdepartmental leaders to implement solutions.
• Proactively facilitates cross-departmental collaboration with clinical departments, Patient Business Service (PBS) center, Payer Strategies, Compliance and other revenue cycle departments to continuously drive strategic denial initiatives and resolution around identified revenue enhancement opportunities.
• Maintains an understanding of regulatory and payer changes.

Revenue Protection Specialist

Support Engineer

• 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.
• 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.

Analyst, Vendor Resource Support, HRSS

Growth Marketing

• Research, collect, analyze & synthesize information / data to support growth initiatives, projects, strategies & leadership decision making.
• Identify opportunities & collaborate with operations, Medical Group & other key stakeholders to address barriers to access & growth.
• Understand market dynamics (e.g., demographics, payer strategies & referral patterns) related to Trinity Health entities & market competitors.
• Interpret & use data to identify growth opportunities & barriers at the system, RHM, service line & programmatic levels.
• Deploy consultative engagement strategies & build trust-based, solutions-oriented relationships with employed & independent physicians, relevant providers & office staff.
• Understand the drivers of physician behavior (e.g., referral management & site of care selection) & how to influence & position Trinity Health / associated facilities to enhance alignment & facilitate growth through removing barriers & developing strategies to optimize opportunities.
• Navigate complex relationships & care delivery systems.
• Act as an advocate & voice of the physician as customer.

Regional Strategic Growth Associate

• 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.

Patient Access Representative I

Accounting Manager

• Performs revenue management functions related to home office third party cost reports, third party appeals, third party payer contract negotiations, analysis of financial impact of changes in third party regulations, and various revenue improvement initiatives.
• 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 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.

Senior Reimbursement Analyst – Revenue Cycle Reimbursement Accounting

• Properly maintains and tracks referrals from beginning to end.
• Accountable for the referral loop by tracking all referral orders including but not limited to specialty referrals and diagnostic referrals.
• Answers, responds to and documents phone calls, requests and questions from patients, physicians, ancillary services or specialty offices in a timely manner.
• Assembles information concerning patient’s clinical background and referral needs.
• Provides appropriate documented clinical information to specialists per referral guidelines.
• Reviews details and expectations regarding the referral with patients.
• Communicates any prep instructions via documented orders or protocol to patient.
• Receives and reviews referral requests; prioritizes orders based on urgency.
• Schedules, problem solves, communicates, and coordinates referral appointments with patient, physician(s), specialists and/or central scheduling.
• Collaborates with essential care team members including: physicians, mid-level providers, LPN's, MA's, Practice.
• Maintains patient confidentiality and abides by all HIPPA guidelines.
• Obtains necessary authorization for referrals and diagnostic testing in timely fashion with proper documentation.
• Works in collaboration with Billing Analyst on denied claims for missing prior authorization or referral within the EMR system.
• Maintains up-to-date knowledge of referral/payer prior authorization requirements, eligibility guidelines and documentation requirements.
• Communicates insurance decisions to patient.
• Conducts follow up calls as necessary to physician offices, patients and payers to complete pre-certification process.
• Confirms payer is in-network with specialist. If not, contacts patient to discuss and make alternate arrangements as necessary per payer guidelines in communication with the care team.
• Act as point of contact for anything referral related, be the expert in this area for the office(s) you are assigned.

Referral Coordinator

Business Analyst

• The Analyst creates, organizes, and manages the lifecycle of HR knowledge information.
• Focuses on analyzing and optimizing information to ensure discoverability and system integrity across platforms such as Workday Help.
• Serves as a technical resource for HR Centers of Excellence (CoEs), LMS teams, and Communications.
• Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience.
• Responsible for distribution of analytical reports.

Analyst, Knowledge Management, HRSS

Business Intelligence Developer

• Designs and implements reporting applications including BI dashboards, reporting cubes, and batch reports
• Works with project lead and business users to gather requirements and prepare specifications
• Develops and maintains test strategies and plans
• Provides production support for Business Intelligence capabilities
• Mentors and trains other BI Developers, Data Analysts, and power users
• Manages scope of deliverables within the release timeframe
• Coordinates with revenue cycle colleagues for infrastructure and tool configurations
• Reinforces and assists defining the vision and direction of the RC Data Analytics team

Senior Business Intelligence Developer, Revenue Cycle

• Qualified and willing to float throughout the hospital and/or throughout multiple hospital locations and/or regions
• Knows, understands, incorporates & demonstrates standard elements of professional practice: Assess, Outcomes Identification / Solutions, Plan, Implement, Evaluate
• Acts independently & appropriately within license, scope of knowledge & experience in practice area
• Retains accountability for delegation, choices, decisions & outcomes
• Collaborates with key stakeholders & contributes to quality & improvement practices & outcomes
• Exhibits agility & willingness to take on new & additional responsibilities
• Embraces new ideas & cultural differences while managing competing priorities

Travel Registered Nurse, RN, Med Surg / Telemetry

Security Engineer

• Design, build, and operationalize a Secure Coding Center of Excellence (CoE)
• Partner with development teams to embed security into the software development lifecycle
• Influence development teams and drive secure coding practice adoption
• Perform platform application security assessments and threat modeling
• Develop and deliver role-based secure coding training and developer enablement programs