Trillium Health NY Care Management Operations Manager in Trillium Health, New York

On the outside,Trillium Healthmay look like a neighborhood health center that provides accessible, affordable services to the community. On the inside, we’re focused on caring for all of an individual’s needs. “Extraordinary care, always,” is not just our noble purpose at Trillium Health, it’s our operational system. Our mission targets the complex vulnerabilities of our community, as we address the social, physical, and behavioral needs of those we serve, all under one roof.

Born from the HIV/AIDS epidemic, Trillium Health has grown into a Federally Qualified Health Center (FQHC) Look A-Like, allowing us to expand our reach and serve those who too often face barriers to care. From primary medical care, to LGBTQ affirming care, we are committed to our community. If you are interested in an organization that truly cares, Trillium Health may be for you.

We are currently recruiting for aCare Management, Operations Manager.

To assure that the planning, service delivery, documentation, and reporting of all department services are in compliance with all regulatory and/or funder’s standards while updating and developing policy and procedures within the Care Management and Supportive Services department. Will be responsible for ensuring charts/documents are maintained in accordance with program standards. The position willwork with thedirector, management team and staffto ensure that these standards, policies and procedures are current and effectively implemented, and willorganize/implement interdepartmental quality training for Case/Care Management, Transportation, Peer Navigation, Housing and all other programs.

Interdepartmental compliance with all regulatory and/or funder standards

  • Assess areas of risk for department prior to internal/external audits and prepare/implement a corrective action plan to address risk areas

  • Maintain documentation of audits and corresponding responses/corrective action plans

  • Responsible to complete regular audits of department charts/files to ensure compliance with regulatory/Medicaid/funder requirements

  • Will obtain documentation and other pertinent information needed for compliance

  • Responsible to work with department management team to review and respond to internal and external audit findings within established timelines

  • Responsible to track and report on Quality Improvement projects/dashboard measures at regularly scheduled Quality Committee meetings

  • Review complaints and incidents filed for additional reporting to regulatory bodies/funders according to policy/procedures and participate in Incident Review Committee to represent department to report on complaint/incident trends and plans to address issues identified

  • In the absence of department managers, will review billing documentation and/or Grant reports to ensure accurate and thorough reporting based on requirements

  • Complete annual satisfaction survey with department clients, document and share results of client survey with teams and assist with addressing issues identified in the survey

  • Develop efficiencies around data collection systems, policy and procedures, reporting systems, and other

  • Cross reference multiple electronic data collection systems to ensure compliance

  • Assist in linking available services and ensure the services have been presented to clients

  • Acts as a liaison with the agency QI/Compliance team for the purpose of reporting regulatory and/or funder changes/perspectives

  • Will ensure enrolled clients are eligible for service reimbursement by the funding source

  • Contract/MOU Compliance and Reporting.

Training

  • Manage the development and implementation of training including regulatory standards and policy and procedures for Care Management and Support Services

  • Manages/organizes training materials for Care Management and Support Services training

  • Ensures that staff are trained on all regulatory changes and that the changes are implemented in program service delivery

Miscellaneous

  • Requires the ability and commitment to respect and support inclusiveness and diversity including but not limited to individuals of different backgrounds, cultures, races, ages, sexual orientations, gender identities or expressions, experiences, opinions, etc.

  • Requires individual demonstration of commitment to the One Trillium behaviors and business impacts and modeling them in the organization.

  • Responsible for maintaining confidentiality of all patient, client, employee, protected and proprietary information.

  • Employees are accountable for meeting the performance standards of their departments and must participate as requested in compliance audits, process improvement and quality improvement plans.

  • Other specific duties as assigned.

Qualifications

  • Strong knowledge of and experience with Medicaid and/or other third party billing.

  • Must have a positive attitude, demonstrate initiative and professionalism.

  • Exceptional organizational skills and the ability to multi-task are required.

  • Computer proficiency and strong attention to detail is required.

  • Bachelor’s degree preferred or equivalent combination of education and experience required.

  • Experience in managing multiple assignments and functioning within a management team.

  • Ability to maintain confidentiality is essential.

Competencies

  • Must be highly organized and have the ability to manage own time and the time of others effectively.

  • Expert level communication (written and verbal) skills, strong decision making ability and attention to detail are equally important.

  • Possess excellent critical thinking ability; using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.

  • Must possess initiative and the ability to effectively lead in an environment in which collaboration is highly valued and reporting relationships are not direct; possess a flexible, “can-do” attitude.

  • Must be team player but can also work on own initiatives independently.

  • The ability to interact with staff and external partners (at all levels) in a fast paced environment, sometimes under pressure, remaining positive, flexible, proactive, resourceful and efficient, with a high level of professionalism is crucial to this role.

  • Experience in assisting with multiple, simultaneous and occasionally complex projects so that they achieve desired results and operate within projected scope, schedule and budget.

  • Exercise discretion handling of financial and other confidential information.

Physical Requirements

While performing the duties of this job the employee is required to stand, sit, walk, use hands to finger, handle, or feel; reach with hands and arms, talk and hear. Occasionally the employee must stoop, bend and lift or move up to 25 lbs. Specific vision abilities required include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.