Regional Director of Health Information Management (HIM) Operations Trinity Health Loyola University Health System Maywood, Illinois Position Specification September 2016 400 TradeCenter, Suite 5900, Woburn, MA 01801 781-938-1975 www.zurickdavis.com
Summary Trinity Health is seeking a Regional Director of Health Information Management (HIM) Operations for the Chicago Region. With a duel reporting relationship to the Chief Financial Officer (CFO) of Loyola University Health System (LUHS) and the System Vice President of Mid Revenue Cycle, the Regional Director will oversee all HIM functions across Loyola University Medical Center, Gottlieb Memorial Hospital, as well Mercy Hospital and Medical Center Chicago (Mercy). The Regional Director of HIM Operations will dedicate the majority of his/her time at Loyola University Medical Center in Maywood, Illinois and will have a regularly scheduled presence at Mercy Chicago. The Opportunity The Regional Director of HIM Operations provides senior level management and leadership of Health Information Management (HIM) activities for those Regional Health Ministries (RHMs) within their region. This individual is responsible for overseeing the activities associated with health record creation, physician completion, clinical documentation improvement, disclosure and retention as applicable as well as ensuring the integrity and quality of the health record. The Regional Director will support all coding activities on at a local level and work collaboratively with system office where coding is managed. All department performance is measured and monitored through the use of productivity metrics and industry established benchmarks. As a member of the Revenue Excellence team, the Regional Director will be accountable for implementing and maintaining system office standards and collaborating with system office HIM leadership when barriers exist to achieving established standards and protocols. Additionally, s/he is responsible for managing local vendor relationships and contracts and utilizing system office contracts as appropriate. The Regional Director will work closely with Regional and RHM Chief Financial Officers, Chief Medical Officer, Patient Financial Services, Patient Access, Utilization Review, Case Management, Information Technology, and clinical areas including nursing, medical staff, and quality services. The Organization The people of Loyola promise patients that we go beyond the illness to treat the whole person. Loyola University Health System Mission Statement LUHS is comprised of a comprehensive Academic Medical Center - Loyola University Medical Center (LUMC), Loyola Gottlieb Memorial Hospital, a community hospital located in nearby Melrose Park, and over 30 suburban satellite locations. It boasts the largest NICU in the state of Illinois and has level 1 trauma status. With 775 faculty and 638 residents and fellows, LUHS has a strong tradition of providing high-quality patient care. Grounded in Jesuit traditions, they seek to provide the best patient care through three mission areas: excellence in clinical service, education of tomorrow s healthcare leaders, and research that improves human health in our communities and around the globe. 2
Since 2012, LUHS has been a member of Trinity Health, one of the largest Catholic health care systems and the 12 th largest health system in the United States. Trinity Health was formed in 2000, when Holy Cross Health System merged with Mercy Health Services in a singular mission. In 2011, LUHS selected Larry M. Goldberg as its new President and Chief Executive Officer. Formerly, the Chief Executive Officer at Vanderbilt University Hospital, he brings a plethora of experience to LUHS, most notably as a veteran of academic medicine and strategic business leadership. U.S. News and World Report magazine has ranked Loyola University Hospital as one of the top 50 hospitals nationwide for heart and heart surgery (29 th ). It was also ranked within the top 50 hospitals for ear, nose, and throat (43 rd ), urology (44 th ), neurology, and neurosurgery (45 th ). These prestigious honors place Loyola University Hospital among an elite group of hospitals that provide the highest caliber of care for some of the nation s sickest patients. Rankings are based upon reputation, death rates, patient safety, and care related factors. In addition to these nationally ranked programs, LUHS also provides transplant programs for heart, lung, kidney, liver, and bone marrow. Culturally, the organization is committed to excellence, service, and compassionate care giving. Quality and Safety are longstanding top priorities for Trinity Health. In order to fulfill its mission, the leadership fosters an environment that encourages innovation, embraces diversity, respects life, and values human dignity. As part of its core value system, LUHS also treats the human spirit. For more details, please visit www.loyolamedicine.org. Mercy Hospital and Medical Center, a member of Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. Mercy Mission Statement Founded in 1852, Mercy holds the privilege of being Chicago s first chartered teaching hospital. Since its founding, Mercy has become an integral part of the city, advancing a mission of providing access to compassionate care to our communities. Today, patients find care that combines world-class medicine with compassion, convenience and an undeniable spirit that sets it apart from other city hospitals. www.mercy-chicago.org Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. It serves people and communities in 21 states from coast to coast with 90 hospitals, and 120 continuing care locations that include: home care, hospice, PACE and senior living facilities - that provide nearly 2.1 million visits annually. With annual operating revenues of about $15.9 billion and assets of about $20.4 billion, Trinity Health returns about $1 billion to its communities annually in the form of charity care and other community benefit programs. www.trinity-health.org 3
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The Position The Regional Director of HIM Operations manages a budget of between $15-$20M and has four direct reports: CDI Manager, Loyola/Gottlieb HIM Operations Manager, Mercy Chicago HIM Operations Manager and Tumor Registry Manager. Scope of the Regional Director of HIM Operations Position: 1. Understands, incorporates, and demonstrates the mission, vision, and values of the Ministry in leadership behaviors, practices, and decisions. 2. Provides regional oversight for all HIM operational processes including, but not limited to, record retrieval, document imaging, record analysis, physician/provider record completion, coding, clinical documentation, release of information, tumor and other registries, birth certificate completion, long term record storage, maintenance and destruction, and accreditation readiness as applicable. 3. Ensures confidentiality of patient data is maintained in accordance with accepted standards of practice based on System Office and RHM policy as well as legal and regulatory requirements. 4. Establishes strategies and goals for innovation, production and quality levels and key benchmarks to appropriately allocate staff resources and achieve optimal outcomes. 5. Develops annual budget to ensure appropriate allocation of resources to support operations and meet organizational goals. Manages operational budget to meet current and projected patient volumes and/or service level requirements. 6. Collaborates with System Office Leadership to resolve local issues impacting centrally managed functions such as transcription and coding. 7. Establishes strategies to better align staffing and resources across multiple entities to achieve greater efficiencies and effectiveness. 8. Implements System Office initiatives, strategies and standards and provides recommendations to improve efficiencies as needed. 9. Oversees the collection, aggregation, and analysis of data to support patient care, patient safety initiatives, and operations. 10. Facilitates the provision of process and technology training of staff to achieve performance goals and maintain appropriate levels of technical proficiency as well as regulatory and accreditation compliance. 11. Oversees human resource functions including recruitment, training and performance management to maintain a high quality workforce. 6
12. Communicates effectively and maintains collaborative working relationships with all stakeholders including System Office and Revenue Excellence leadership and associates, RHM leadership and associates, providers, and clinical staff to achieve high level performance and timely issue resolution. 13. Oversees the management and analysis of third party payer audits and denials to identify and trend issues, formulate appeals, and implement actions/education to prevent future denials. 14. Participates in local, regional, and system-level committees and/or workgroups to establish best practices, policies and procedures to support a compliant, quality health record. 15. Coordinates activities of HIM functions with Patient Access, Patient Financial Services and clinical areas to develop process improvements to strengthen the patient experience and revenue cycle. 16. Maintains current knowledge of regulatory requirements and industry standards for clinical documentation, electronic health records, health information exchanges, patient portals, and data integrity to ensure a complete and compliant patient health record. 17. Provides project management oversight for the implementation of new programs, procedures, processes, and software. 18. Participates in local, regional and national HIM activities and professionally represents Trinity Health at these functions. 19. Performs other duties as assigned by leadership such as developing system-wide policies and procedures or leading special projects. 20. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health 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. Candidate Qualifications The ideal candidate for this position will be Master s prepared in Business Healthcare Administration or Health Informatics. S/he will bring five to ten years of progressive management / leadership experience working within an HIM setting and be comfortable operating as a Working Director with the ability to comfortably navigate both strategy and operations. In addition, the selected candidate Will be certified in Registered Health Information Administration, Health Information Technology, or Clinical Informatics. This is a requirement. Must possess a comprehensive knowledge of hospital HIM and revenue cycle management and electronic medical record technology with a minimum of five years of experience managing acute care HIM services. Experience managing multiple hospital HIM departments is preferred. 7
Bring experience with the electronic health record, health information systems, and other healthcare applications. Bring experience with regulations and accreditation standards, knowledge of specific state and federal requirements and standards related to the management of health information. Possess expertise in healthcare compliance: knowledge of privacy and security regulations, confidentiality, laws, access and release of information practices. Must demonstrate broad based knowledge of health information management, coding practices, transcription services, patient access, forms management, technology projects, and insurance and patient billing and collections practices. Must possess demonstrated knowledge of process improvement techniques and their application as well as the ability to lead implementation and process improvement projects. Ability to manage multiple projects simultaneously. Demonstrate a broad based knowledge of third party payer Medical Necessity review guidelines, prospective payment systems, case mix analysis, and core (quality indicators), and OIG initiatives. Be adept at interpreting federal and state regulations, and accreditation standards; ability to recommend, design and implement procedures for compliance with regulations and standards. Candidate Attributes The poise and sophistication to operate in an academic medical center and health systemwide role and promote the important mission and activities of Trinity Health in regard to all HIM functions. Be comfortable as part of a high performing, collaborative team whose shared mission is the provision of measurably world class healthcare. The ability to support and partner with key stakeholders, executive / physician leadership, clinicians and peer groups to drive the continuous improvement in the arena of HIM Operations. S/he will possess the personal charisma to motivate and inspire others into action and bringing a can do proactive approach to the HIM Operations. A comprehensive understanding of the changing landscape as it relates to healthcare delivery, including new payment models such as accountable care organizations and bundled payment programs and their impact on the management of all health documentation. A high level of Emotional Intelligence. Being highly skilled at building relationships and gaining buy in through engagement, listening, and possessing a transparent communication style. The ability to foster an atmosphere of respect, trust, and aligned commitment to organizational goals consistent with the Jesuit mission of LUHS and the Mission and Core Values of Trinity Health. Working collaboratively with peers and others at the LUHS, Mercy Chicago and all affiliated organizations. The ability to manage conflicting priorities and adapt to changing demands in a complex academic setting. Being a skilled facilitator who understands the nuances of serving many masters in a complex and matrixed environment. 8
Leadership Competencies Achieves excellence by being action oriented, decisive and follows through and aligns resources to accomplish objectives. Uses effective strategies to facilitate change initiatives and overcome resistance to change. Builds cooperative relationships and alliances throughout the organization and relates to many different types of people including subordinates, superiors, peers, and outsiders. Able to pull people together to work in highly effective teams and inspire them to perform at their best. Understands complex issues and develops solutions that effectively address the problem. Understands the role of emerging technology and its impact on operational effectiveness and organizational change. Lives out a set of deeply held personal beliefs and honors a spirit and presence greater than self and connects these to the Trinity Health Mission and Core Values. Critical Success Factors Within the first 18 months of hire, the new Director of HIM Operations will be charged with specific goals and objectives that s/he must meet in order to be successful. The Regional Director of HIM Operations will: Demonstrate his or her abilities as a relationship person and have the ability to build sustainable relationships across the region and at all levels. S/he will be comfortable working as part of a team and within a culture that is humble and respectful, but also possess the self-confidence to work alongside a diverse group of people and personalities to drive a successful HIM program. Build a good working relationship with the HIM staff and team - includes accessibility, the ability to remove barriers that impact HIM Operations and team. S/he must also be approachable, transparent in their communication style and bring a compassionate but accountable style of leadership to their work. Work closely with the Chief Health Information Officer (CHIO) to reduce the amount of paper documentation being generated which includes the development and deployment of a plan to migrate paper records into the EMR (Epic). Assess overall operations and identify opportunities for improvement and create a work plan with timelines to complete all the work. Work with the System Office to remove barriers that impact coding. All coding operations are managed from the System Office in Livoina, Michigan. Support Clinical Documentation Improvement in achieving a budget target of approximately $1M in incremental revenue. Develop and deploy an appropriate destruction policy plan for paper records that have passed the legal retention mark and can be legally destroyed within an agreed timeframe. The Community Loyola University Medical Center and Gottlieb Memorial Hospital are located ten miles west of downtown Chicago, while Mercy is located directly in the downtown area and serves an urban patient population. 9
Chicago is renowned for many things; its size (almost 3,000,000 residents), its cultural diversity, which spans almost 100 designated neighborhood areas and its 26 miles of beautiful lakefront. It is estimated that there are over 7,000 restaurants and almost 400 theaters and art galleries combined. As architecturally diverse as it is culturally, it enjoys a national reputation for being a sports town, is famed for its jazz and blues music, and currently boasts some of the most accomplished chefs in the nation. A multicultural city that thrives on the diversity of its neighborhoods, Chicago embodies the values of America s heartland - integrity, hard work, and community that reflects the ideals in the social fabric of its ethnic history. Today, Chicago is a leader in reforming public schools, enhancing public safety and security initiatives that provide affordable housing in attractive and economically sound communities, ensuring accessibility for all, and fostering social, economic and environmental sustainability. Compensation A compensation package will be constructed commensurate with the background and experience of the selected candidate and includes a comprehensive benefits program. Most significant is the opportunity to assume a key leadership role in a thriving organization renowned for its delivery of high quality patient care and its compassionate approach to treating the patient in a holistic manner, one that is consistent with Trinity and Loyola philosophy and values. For More Information We appreciate all referrals. Interested parties please send resume and cover letter to TrinityRHIM2181@ZurickDavis.com. For additional questions, please contact Fernando Limbo or Annette Cooke at 781.938.1975. All contact with ZurickDavis will remain confidential. Trinity Health and Loyola University Health System are Equal Opportunity Employers 10