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(Remote) Integrity & Compliance - Program Manager
<h2><b>Employment Type:</b></h2>Full time<h2><b>Shift:</b></h2><p style="text-align:inherit"></p><h1><b>Description:</b></h1>Essential Functions <br><br> <br><br>Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. <br><br> <br><br>Leadership: <br><br>Providing advice, guidance & leadership to RHM & Region leaders in developing strategies & in the achievement of performance goals. <br><br>Enable Collaboration across & within service area, RHM & Regions to ensure consistency & integration of strategy & operations <br><br> <br><br>Direction & Growth: <br><br>Providing advice, guidance & leadership to service area, functional area, RHM & Regions. <br><br>Leading standardization / systemness & optimization of policy, process, methodology, establishing a national community of practice. <br><br>Oversee Vendor / Contract Labor Management including centralizing strategy & optimizing spend. <br><br> <br><br>Strategic Support & Accountability: <br><br>Collaborates in system-wide strategy development & deployment of functional area priorities & initiatives. <br><br>Responsible for supporting regional efforts to comply with functional area priorities. <br><br>Accountable for the selection, evaluation & overall success of the functional leadership teams. <br><br>Organization-wide focal point for establishing functional strategies & governance over financials & staffing. <br><br>Accountable for communication between service area functional area, RHM & Region leaders. <br><br> <br><br>Operational Delivery <br><br>Responsible for measuring & reporting KPIs / metrics &value delivery. <br><br>Providing advice, guidance & leadership for the colleague life cycle. <br><br> <br><br>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.<div><div><p></p><p><b><span>Functional Role (not inclusive of titles or advancement career progression)</span></b><span> </span></p></div><div><p><span> </span></p></div><div><p><span><span>Assist the Integrity and Compliance Director with guiding and managing the compliance</span><span><span> </span>activities and</span><span><span> </span>initiatives</span><span><span> </span>for assigned ministry(</span><span>ies</span><span>)</span><span>. <span> </span></span><span>Provides advice,<span> </span></span><span>guidance</span><span><span> </span>and program management to ministry leaders in developing</span><span>,<span> </span></span><span>implementing</span><span><span> </span>and<span> </span></span><span>attaining</span><span><span> </span>program goals<span> </span></span><span>while ensuring</span><span><span> </span>alignment to</span><span><span> </span>compliance strategies</span><span>. <span> </span></span><span>Conducts investigations for local ministry</span><span><span> </span>and provides recommended action in response to outcome of investigation</span><span>.</span><span> <span> </span></span><span>Participate</span><span>s</span><span><span> </span>in Service Area and Enterprise Integrity and Compliance projects with a focus on standardization and process improvements.</span></span><span> </span></p></div><div><ul><li><p><span><span>Support the Integrity and Compliance Director in developing, executing, and overseeing compliance initiatives within the ministry.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Provide expert advice and strategic guidance to ministry leaders on program goals and compliance strategies.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Lead and conduct internal investigations related to compliance concerns, ensuring thorough,<span> </span></span><span>timely</span><span>, and objective outcomes.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Deliver well-documented recommendations for corrective actions based on investigative findings.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Partner with leaders across local ministries and enterprise functions to implement and sustain compliance strategies.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Actively<span> </span></span><span>participate</span><span><span> </span>in Service Area and Enterprise-level compliance projects, focusing on process improvement and standardization.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Collaborate on the development and rollout of organization-wide policies, training, and communication tools to foster a culture of ethics and compliance.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Monitor emerging risk areas and regulatory changes, ensuring proactive and<span> </span></span><span>appropriate organizational</span><span><span> </span>response.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Contribute to audit readiness activities and help strengthen internal controls across the ministry.</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Track compliance performance metrics and support continuous improvement initiatives to enhance overall program effectiveness.</span></span><span> </span></p></li></ul></div><div><p><span> </span></p></div></div><div><div><p><b><span>Minimum Qualifications</span></b><span> </span></p></div><div><p><span><span>Bachelor’s</span><span><span> </span>level degree in business</span><span>,<span> </span></span><span>health administration,<span> </span></span><span>or a</span><span><span> </span>related field</span><span>, a law degree, or an equivalent combination of education & experience</span><span>.</span></span><span> </span></p></div><div><p><span> </span></p></div><div><p><span><span>Minimum of five 5 years of relevant experience with increasing levels of responsibility in health care compliance &/or consulting including regulatory compliance, program metrics, performance assessment, & reporting outcomes, etc. </span></span><span> </span></p></div><div><p><span><span>Must<span> </span></span><span>possess</span><span><span> </span>a thorough understanding and knowledge of health care legal and regulatory practices, financial and internal control systems/procedures.</span></span><span> </span></p></div><div><p><span> </span></p></div><div><p><span><span>Previous</span><span><span> </span>project, program,<span> </span></span><span>supervisory</span><span><span> </span>or management experience.</span></span><span> </span></p></div><div><p><span> </span></p></div><div><p><b><span>Additional Qualifications (nice to have)</span><span> </span></b><span> </span></p><p></p></div><div><p><span><span>Experience within a health care organization (including ambulatory and hospital settings) or equivalent work<span> </span></span><span>experience<span> </span></span><span>involving clinical documentation and coding reviews</span><span><span> </span>and working knowledge of<span> </span></span><span>Conditions of Payment including<span> </span></span><span>government<span> </span></span><span>and</span><span><span> </span>third- party payer regulations.</span></span><span><span><span> </span>Must</span><span><span> </span></span><span>understand and have<span> </span></span><span>expertise</span><span><span> </span>with Patient Driven Payment Models, Patient Driven Groupings Models, IRF-PAI and OASIS requirements.</span><span><span> </span></span><span>Comprehensive understanding of Medicare Physician Fee Schedule and Medicare Claims Processing Manual for professional services</span><span>.<span> </span></span><span>.</span><span> <span> </span></span><span>Comprehensive understanding of Conditions of Participation and Accreditation Standards. </span></span><span> </span></p></div><div><p><span> </span></p></div><div><p><span><span>CHC, CHPC, CHRC, CCEP or equivalent certification. </span></span><span> </span></p></div><div><p><span> </span></p></div><div><p><span><span>Lean/Six Sigma training and/or certification</span></span><span> </span></p></div><div><p><span> </span></p></div></div><div><div><p><b><span>Physical & Mental Requirements & Working<span> </span></span></b><b><span>Conditions (General Summary) </span></b><span> </span></p></div><div><p><b><span>Direct Healthcare Services / Indirect Healthcare / Support Services:</span></b><span><span> </span></span><span> </span></p></div><div><ul><li><p><span><span>Exposure to conditions which may be considered unpleasant to sight, touch, sound<span> </span></span><span>& /<span> </span></span><span>or smell.<span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Exposure to fumes, odors,<span> </span></span><span>dusts</span><span>, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.)</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Exposure to or subject to noise, infectious waste, diseases & conditions</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Exposure to interruptions, shifting<span> </span></span><span>priorities</span><span><span> </span></span><span>& stressful</span><span><span> </span>situations</span><span>. </span><span> <span> </span></span></span><u><span>Frequent</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Ability to follow tasks<span> </span></span><span>through to</span><span><span> </span>completion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens over<span> </span></span><span>long periods</span><span><span> </span>of time & work on concurrent tasks / projects</span><span>. </span><span> <span> </span></span></span><u><span>Frequent</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Ability to read small print, hear sounds & voice / speech patterns, give / receive instructions & other verbal communications (in-person<span> </span></span><span>& /<span> </span></span><span>or over the phone / computer / device / equipment assigned) with some background noise</span><span>. </span><span> <span> </span></span></span><u><span>Frequent</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Perform manual dexterity activities & / or grasping / handling</span><span>. </span><span> <span> </span></span></span><u><span>Continuous</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Ability to climb, kneel,<span> </span></span><span>crouch & /</span><span><span> </span>or<span> </span></span><span>operate</span><span><span> </span>foot controls</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Use a computer / other technology</span><span>. </span><span> <span> </span></span></span><u><span>Frequent</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Sit with the ability to vary / adjust physical position or activity</span><span>. </span><span> <span> </span></span></span><u><span>Frequent</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Maintain a safe working environment & use available personal protective equipment (PPE)</span><span>. </span><span> <span> </span></span></span><u><span>Continuous</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Comply with</span><span><span> </span>Trinity Health’s Code of Conduct, policies, procedures & guidelines</span><span>. </span><span> <span> </span></span></span><u><span>Continuous</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Ability to<span> </span></span><span>provide assistance</span><span><span> </span>in the event of an emergency.</span><span><span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><p><span><span> </span></span><span> </span></p></div><div><p><b><span>Direct Healthcare Services:</span></b><span> </span></p></div><div><ul><li><p><span><span>Perform activities that require standing / walking with the ability to vary / adjust physical position or activity</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Lift a maximum of 30 pounds unassisted</span><span>. </span><span> Occasional</span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Use upper & lower extremities, engage in bending / stooping /<span> </span></span><span>reaching</span><span><span> </span>& pushing / pulling</span><span>. </span><span> O</span></span><u><span>ccasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Work indoors (subject to travel requirements) under <span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">temperature-controlled</span> & well-lit conditions.<span> </span></span></span><u><span>Continuous</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Encounter worksites (e.g., patient homes) or travel to worksites that may have variable internal & external environmental conditions</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Perform work that involves physical efforts (e.g., transporting, moving, positioning & / or ambulating patients)</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><p><span><span> </span></span><span> </span></p></div><div><p><b><span>Indirect Healthcare / Support Services:</span></b><span> </span></p></div><div><ul><li><p><span><span>Perform activities that require standing / walking with the ability to vary / adjust physical position or activity</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Lift a maximum of 30 pounds unassisted</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span><span> </span></span><span> </span></p></li></ul></div><div><ul><li><p><span><span>Experience of<span> </span></span><span>long periods</span><span><span> </span>of walking / standing / stooping / bending / pulling & / or pushing</span><span>. </span><span><span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Encounter a clinical / patient facing / hands on interactive work environment</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Work indoors (subject to travel requirements) under <span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">temperature-controlled</span> & well-lit conditions</span><span>. </span><span> <span> </span></span></span><u><span>Continuous</span></u><span> </span></p></li></ul></div><div><ul><li><p><span><span>Work outdoors with variable external environmental conditions</span><span>. </span><span> <span> </span></span></span><u><span>Occasional</span></u><span> </span></p></li></ul></div><div><p><i><span>Average Workday Activity: Occasional - O (1% - 33%), Frequent - F (34% - 66%), Continuous - C (67% - 100%)</span></i><span> </span></p><p></p></div><div><p><span>Hourly pay ranges: $47.23 - $70.85 </span></p></div></div><p></p><p></p><p></p><p><b>Our Commitment </b></p><p></p><p><span>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.</span></p>