Position Purpose
Responsible for developing and implementing standardized tools, roles, and systems to support Case Management Services across Trinity Health. Accountable for establishing the metrics and achieving the targets for Case Management Services in collaboration with other System Office and Regional Health Ministry Organization departments and administrators. Provides leadership to the Service Areas to pursue excellent member experiences including access to care.
Essential Functions
1. Knows, understands, incorporates, and demonstrates the Trinity Health mission, vision, values, actions and promise in leadership behaviors, practices, and decisions.
2. Directs, leads, and manages System Office colleagues providing both virtual and onsite support, mentoring, and management.
3. Directs case management services across Trinity Health. Leads change effectively through others, assuring sustained process improvements.
4. Leads operational improvements that facilitate standardization of case management services across the organization and across the continuum of care, directly or through the influence of others at the Regional Health Ministries.
5. Supports the development of high performing teams in case management across the organization.
6. Coordinates system-wide reporting of metrics and outcomes, holding Regional Health Ministry and System Office associates accountable for accurate and timely data submissions. Analyzes and interprets data to direct improvement efforts.
7. Incorporates and integrates related theories, evidence, practice standards and other established knowledge into standardized processes and functions, applying current trends to the system, where applicable.
8. Contributes to the ongoing refinement of the strategic plan for case management services, identifying resources needed, risks and contingency plans.
9. Leads reorganization of structures, policies, practices, etc. to better achieve operational and system targets.
10. Leads system-wide quarterly/annual director of case management meetings for the purpose of ongoing departmental growth, director growth and development and communication. Provides or facilitates training and coaching of System Office and Regional Health Ministry associates, as needed, to assure sustained improvements.
11. Monitors effectiveness of tools, roles, and systems, working though ambiguous situations to clarify directions and assure compliance.
12. Oversees compliance with regulations, laws and ethics via audits and direct observation.
13. Develops a network of case management colleagues across the country to maintain awareness of ongoing regulatory and legislative changes and methods to maintain compliance.
14. Establishes partnerships with chief nursing officers, physician executives and other key leaders across the organization related to case management services, including Trinity Health At Home, Trinity Senior Living Communities and other community agencies. Represents case management services at various corporate and hospital committees.
15. Participates in review of organizational system contracts for issues pertaining to denial management, timelines for authorization of services and other case management-related agreements.
16. 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
LEADERSHIP COMPETENCIES
As a Trinity Health Leader, the incumbent is expected to demonstrate leadership traits which support our Mission Statement and Core Values as identified below:
Mission Statement: We, Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities.
Core Values:
•Reverence: We honor the sacredness and dignity of every person.
•Commitment to Those who are experiencing poverty: We stand with and serve those who are experiencing poverty, especially those most vulnerable.
•Safety We embrace a culture that prevents harm and nurtures a healing, safe environment for all.
•Justice: We foster right relationships to promote the common good, including sustainability of Earth.
•Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care.
•Integrity: We are faithful to those we say we are.
MINIMUM QUALIFICATIONS
1. Must possess a comprehensive knowledge of case management services, as normally obtained through a Bachelor’s degree in Nursing and a Master’s degree in Nursing, Administration, Public Health or related field, or a Master’s degree in Social Work and at least ten (10) years of case management experience, including three (3) years at a director level, or an equivalent combination education and experience.
2. Valid Registered Nurse license or certification/licensure as Social Worker in a State that Trinity Health has presence.
3. Current certification in case management, ACM (Accredited Case Manager), CMAC (Case Management Administrator Certification), AACM (American Academy of Case Management) and CCM (Certified Case Manager) preferred.
4. A personal presence which is characterized by a sense of honesty, integrity, and caring with ability to inspire and motivate others to promote the philosophy, mission, vision, goals, action, promise, and values of Trinity Health.
5. Exceptional interpersonal and relationship building skills required to effectively collaborate with multiple stakeholders to obtain management, staff, and physician involvement and accountability in achieving specific outcomes.
6. Ability to simultaneously address and prioritize multiple projects, demands and issues.
7. Must possess excellent verbal and written communication skills, presentation skills, advanced analytical skills, be well organized, and maintain a highly professional manner and appearance.
8. Demonstrated ability to operate in a collaborative, shared leadership environment.
9. Demonstrated ability to effectively lead and manage teams and people through influence, without direct reporting relationships.
10. Demonstrated high degree of self-motivation, assertiveness, and goal-attaining capabilities.
11. Effective negotiation, persuasive, business planning and verbal/written communication skills.
12. Ability to be flexible and adaptable to changing processes and schedule requirements.
13. Demonstrated ability to acknowledge and analyze formal and informal assessments of health care market trends, locally and across the country, and the impact/potential impact on the organization.
14. Possesses knowledge of budget processes, quality improvement, report distribution, TJC standards, state, and federal regulations, six sigma and LEAN methodologies.
15. Proficient in common software applications (Word, Excel, Power point).
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is 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, status as a protected veteran, or any other status protected by law.