Purpose
Accountable for leading guiding & directing the functional responsibilities within an area of assignment. Enable ministry-level or enterprise-wide functional strategy to address internal or external business & regulatory issues. Provide functional expertise & ensure fulfillment of performance & service standards. Responsible for consistent operating performance & achieving financial goals. Identifies defines & solves complex problems that impact the management & direction of the business. Collaborates with Services Areas Regions & Health Ministries to ensure consistency & integration of strategy & operations while maintaining awareness of new industry developments & standards. Provides decision support operations & / or optimization leadership focus.
Essential Functions
Our Trinity Health Culture: Knows understands incorporates & demonstrates our Trinity Health Mission Values Vision Actions & Promise in behaviors practices & decisions.
Leadership:
Providing advice guidance & leadership to RHM & Region leaders in developing strategies & in the achievement of performance goals.
Enable Collaboration across & within service area RHM & Regions to ensure consistency & integration of strategy & operations
Direction & Growth:
Providing advice guidance & leadership to service area functional area RHM & Regions.
Leading standardization / systemness & optimization of policy process methodology establishing a national community of practice.
Oversee Vendor / Contract Labor Management including centralizing strategy & optimizing spend.
Strategic Support & Accountability:
Collaborates in system-wide strategy development & deployment of functional area priorities & initiatives.
Responsible for supporting regional efforts to comply with functional area priorities.
Accountable for the selection evaluation & overall success of the functional leadership teams.
Organization-wide focal point for establishing functional strategies & governance over financials & staffing.
Accountable for communication between service area functional area RHM & Region leaders.
Operational Delivery
Responsible for measuring & reporting KPIs / metrics &value delivery.
Providing advice guidance & leadership for the colleague life cycle.
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.
Functional Role (not inclusive of titles or advancement career progression)
Provides leadership & strategic oversight of the Trinity Health Medical Groups (THMG) Ambulatory Clinical Documentation Integrity program.
Designs & builds structure workflows & guidance of best practice documentation standards to ensure coding compliance & minimize audit liability.
Provides emphasis on adherence to CMS & other insurance carrier standards optimizing revenues & the avoidance of monetary settlements from third party audits.
Works with providers & ambulatory practice leaders to develop accurate effective efficient & compliant documentation processes that ensure patient quality for all services provided & clinical documentation exists to support appropriate coding & billing.
Stays current with organizational alternate payment models & contracting to help prioritize work assignment for ambulatory clinical documentation integrity specialists. Develops & sustains working relationships with providers advanced practice providers & administrators to promote success of the Clinical Documentation Integrity program.
Ensures educational materials & programs are available to staff & providers around complete & compliant documentation.
Assists in the development of software applications in assigned areas while identifying & resolving trends with process gaps causing errors in documentation.
Minimum Qualifications
Bachelors degree in Business Administration Healthcare Administration Nursing or related field or equivalent combination of education & experience
Experience with compliant healthcare documentation HCC coding requirements alternate payment models in a multi-facility integrated health care delivery system revenue cycle or consulting experience with progressive responsibility in management or leadership experiences in clinical documentation integrity coding healthcare quality or equivalent
Certified Risk Adjustment Coder (CRC) Certified Clinical Documentation Integrity (CDI) Certified Clinical Documentation Specialist Outpatient (CCDS-O) Certified Documentation Expert Outpatient (CDEO) or Certified Documentation Integrity Practitioner (CDIP) credential with coding or clinical documentation integrity experience
Ambulatory or outpatient experience with Medicare Medicaid & other third-party billing rules & regulations
Additional Qualifications (nice to have)
Masters degree in nursing HIM or related healthcare field
Physical & Mental Requirements & Working Conditions (General Summary)
Direct Healthcare Services / Indirect Healthcare / Support Services:
Exposure to conditions which may be considered unpleasant to sight touch sound & / or smell. Occasional
Exposure to fumes odors dusts mists & gases biohazards / hazards (mechanical electrical burns chemicals radiation sharp objects etc.). Occasional
Exposure to or subject to noise infectious waste diseases & conditions. Occasional
Exposure to interruptions shifting priorities & stressful situations. Frequent
Ability to follow tasks through to completion understand & relate to complex ideas / concepts remember multiple tasks & regimens over long periods of time & work on concurrent tasks / projects. Continuous
Ability to read small print hear sounds & voice / speech patterns give / receive instructions & other verbal communications (in-person & / or over the phone / computer / device / equipment assigned) with some background noise. Frequent
Perform manual dexterity activities & / or grasping / handling. Occasional
Ability to climb kneel crouch & / or operate foot controls. Occasional
Use a computer / other technology. Frequent
Sit with the ability to vary / adjust physical position or activity. Continuous
Maintain a safe working environment & use available personal protective equipment (PPE). Continuous
Comply with applicable Code of Conduct policies procedures & guidelines. Continuous
Ability to provide assistance in the event of an emergency. Occasional
Direct Healthcare Services:
Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Frequent
Lift a maximum of 30 pounds unassisted. Occasional
Use upper & lower extremities engage in bending / stooping / reaching & pushing / pulling. Occasional
Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. Continuous
Encounter worksites (e.g. patient homes) or travel to worksites that may have variable internal & external environmental conditions. Occasional
Perform work that involves physical efforts (e.g. transporting moving positioning & / or ambulating patients). Occasional
Indirect Healthcare / Support Services:
Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional
Lift a maximum of 30 pounds unassisted. Occasional
Experience of long periods of walking / standing / stooping / bending / pulling & / or pushing. Occasional
Encounter a clinical / patient facing / hands on interactive work environment. Occasional
Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. Continuous
Work outdoors with variable external environmental conditions. Occasional
Average Workday Activity: Occasional - O (1% - 33%) Frequent - F (34% - 66%) Continuous - C (67% - 100%)
The above statements provide a representative description of the nature & level of work being performed by persons assigned to positions within this job description. This is not an exhaustive list of essential functions conditions & duties; other job-related tasks may be required. Additional detail may be provided by policies procedures guidelines protocols standards & other communications. Requests for reasonable accommodation will be considered in compliance with federal state & local law.
Our Commitment
Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.
Required Experience:
Manager
Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity ... View more