see associated job description
1. Know, understand, incorporate, and demonstrate the Mission, Vision, Values and Guiding Behaviors of Trinity
Health and Trinity Health PACE (TH PACE) in behaviors, practices, and decisions.
2. Consistently demonstrate (leads by example) TH PACE Values to all internal and external customers
(participants, visitors, volunteers, and colleagues.) Create and maintain an atmosphere of warmth, propagating a
calm environment throughout the office.
3. Execute assignments in a culture that is shared and collaborative across all divisions within TH PACE.
4. Reflects the skills knowledge and abilities serving in the role of a leader. Define and share a strategy and vision;
align resources toward achievement of organization results; grow and sustain the organization; identify, lead, and
5. Establish and/or maintain as a member of the leadership team a plan to achieve operating goals.
6. Promote and maintain collaborative relationships with managers, peers, direct reports and customers by
effectively fostering a team environment, building consensus and resolving conflicts.
7. Maintain department budget, place orders for equipment and supplies as necessary. Identify financial
vulnerabilities and make cost reduction recommendations as needed.
8. Evaluate, develop, mentor, coach, counsel and discipline department staff. Supports other personnel from other
departments through coaching and mentoring to help achieve optimum standard of excellence. Addresses issues
of concern through courageous conversation and notifies department manager of any interactions requiring
9. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, TH PACE Corporate
Integrity Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a
manner that reflects honest, ethical and professional behavior.
10. In light of a disaster will know your disaster recovery, crisis management and business continuity plans and act
within your role that is developed within the business continuity plan. Which may include working at another
location, remotely from home, and maintaining constant contact with key personnel.
11. Attend and participate in scheduled training, in-service training, mandatory annual in-service training and
educational classes as required/needed.
12. Collaborate with enrollment team and participant families on any outstanding issues causing a delay in enrollment.
Maintain the master, billable census for each month including demographic, insurance and eligibility information.
Download appropriate Medicaid and Medicare payment reports and reconcile to monthly census. Submit reconciliations in appropriate systems. Ensure nursing home participants are enrolled in RFMS system and
communicate transition to CAO for proper Medicaid payments (if applicable). Create, submit and follow up with
invoicing for all third-party payers (private, VA, etc.). Schedule and lead A/R review meetings to assure collection
of all funds due the program. Inform payers of any payment discrepancies and work with them to resolve
outstanding A/R issues. Implement appropriate collection procedures in accordance with Program policies.
13. Maintain super user knowledge of all internal and external software systems required for revenue operations.
Conduct analysis of reports which includes (as applicable): Gentran- (DIR, COB, etc), Pharmastar- (FIR, PDE,
BvD, ESRD, MA only, new enrollments), Plexis- (RAPS), MMR- (correct zip codes, ESRD and hospice status).
Review RAPS and Encounter Data CMS return files, correct errors and resubmit. Perform or supervise various
Part D Reporting requirements with CMS and Pharmacy Benefit Manager (PBM): Medicare Part D Compliance
reports such as TrOOP letters, P2P's, Employee Subsidy verifications, MSP's, PDE quarterly audits, annual DIR
submissions, P2P submissions, attestations, etc. Download and coordinate response to various PBM reporting to
14. Prepare Medicare Part D bid for assigned PACE location(s), in collaboration with System Office PACE Finance.
15. Participate in interdisciplinary team meetings and reviews and is aware of authorizations for participant services,
including high cost services and diagnoses. Complete the monthly Incurred But Not Reported (IBNR) analysis
and submit related journal entry for posting. Reviews accounts payable and liability/expense accounts and
prepares monthly accrual entries to ensure proper recording of monthly expenses.
16. Prepares financial information for presentation at Monthly Operations Review (MOR) meetings. Identifies trends
and items requiring attention by operations.
1. Must possess a comprehensive knowledge of general accounting principles and finance, as normally obtained through
a Bachelor's degree in accounting, finance or business, and a minimum of three (3) years' experience. A combination
of education and experience may be acceptable. Experience with Medicare, Medicaid and electronic filing is highly
2. State of North Carolina - Must have Employee Medical Statement that meets the requirements of the Standards
completed prior to beginning employment, signed within previous 12 months by an MD, NP or PA, indicating that
the employee has no illness or health condition that would pose a risk to others and can perform the duties assigned in
3. Must be action-oriented, have business acumen, manage conflict well, be customer focused, have high decision
quality, flexibility to adapt to ongoing change and have organizational agility. Ability to work with minimal
supervision and exercise independent judgment.
4. Possess interpersonal skills to drive collaboration, commitment and productivity when working with cross functional teams, customers and end users. Must be comfortable functioning in a virtual, collaborative shared
5. Demonstrates superior written and verbal communication and presentation skills appropriate for audience
comprehension. Well-developed communication skills, both written and oral, that may be used either in an on-site
or virtual environment is required. Able to communicate effectively with individuals and groups representing
6. Comprehensive to expert proficiency with Microsoft product suite (MS Word, Excel, Power Point, etc.); basic
knowledge and experience with electronic mail and calendaring system. Knowledge of general ledger systems
necessary, PeopleSoft experience preferred. Ability to type with speed and accuracy. Ability to use other software
as required to perform the essential functions of the job.
7. Possesses a high degree of personal accountability, responsibility and independent decision-making abilities with
the skills to plan, organize, develop, implement and interpret programs, goals, objectives, policies and procedures
of the organization in line with mission, vision, and philosophy of TH PACE.
8. Excellent organizational skills. Ability to perform multiple duties and functions related to daily operations and maintain excellent customer service skills. Ability to perform frequent detailed tasks and provide immediate service with frequent interruptions. Ability to change and be flexible with work priorities. Strong problem-solving skills.
9. Ability to research, analyze and assimilate information from various on-site or virtual sources based on technical and experience-based knowledge. Must exhibit critical thinking skills and possess the ability to prioritize workload.
10. Position may require some travel (less than 25%) within the Centers geographic region and to System Office in Livonia, MI.
PHYSICAL AND MENTAL REQUIRMENTS AND WORKING CONDITIONS
1. Must be able to adapt to frequently changing work parameters and adapt to work priorities that frequently change. Must be able to work on a variety of tasks/projects in physical or virtual environments that may be stressful with individuals having diverse personalities and work styles.
2. Must be able to see and hear or use prosthetics that will enable these senses to function adequately so that the requirements of this position can be fully met.
3. Primarily works inside with frequent kneeling, crouching, reaching, lifting, sitting, walking, bending and lifting. Must be able to push, pull, move and or lift a minimum of 20 pounds if applicable.
• Physical mobility that includes movement from place to place.
• Must be able to sit for long periods of time.
• Physical agility, that includes ability to maneuver body while in place.
• Dexterity of hands and fingers.
• Coordination, including eye-hand, hand-foot. Must possess the above ability with or without the use of prosthetics that will enable adequate functionality so that the requirements of this position can be fully met.
4. Subject to exposure to noise, infectious waste, diseases, conditions, etc. including TB, HIV, HEP B viruses. May be subject to the handling of and exposure to hazardous chemicals.
5. Must be able to speak, read and write the English language in an understandable manner.
6. Must be able to relate to and work with ill, disabled, elderly, emotionally upset and at times hostile customers. Must possess the ability to deal tactfully with personnel, participants, family members, visitors, government agencies/personnel and the general public.
7. Must not pose a direct threat to the health or safety of other individuals in the workplace.
8. Must be able to cope with the mental and emotional stress of the position. Must be able to comply with organizational policies and procedures.
9. Must be able to spend majority of work time utilizing a computer, monitor, and keyboard. Must be able to work with frequent interruptions and perform detailed tasks.
10. Must meet the general health requirements set forth by the policies of this organization, which include a medical and physical examination.
11. May be required to work beyond normal working hours, on weekends and other positions temporarily when necessary and may be subject to call back during emergency conditions. May be required to work on shifts other then those which originally hired.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
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