(Remote) Integrity & Compliance - Program Manager

Trinity Health•Livonia, MI

1d•Remote

About The Position

This role is responsible for assisting the Integrity and Compliance Director with guiding and managing compliance activities and initiatives for assigned ministries. The Program Manager provides advice, guidance, and program management to ministry leaders in developing, implementing, and attaining program goals while ensuring alignment with compliance strategies. This position also conducts investigations for local ministries and provides recommended actions based on the outcomes. Additionally, the role participates in Service Area and Enterprise Integrity and Compliance projects, focusing on standardization and process improvements. The Program Manager supports the development, execution, and oversight of compliance initiatives, offers expert advice and strategic guidance to ministry leaders, and leads internal investigations related to compliance concerns. The role collaborates on organization-wide policies, training, and communication tools to foster a culture of ethics and compliance, monitors emerging risk areas, contributes to audit readiness, and tracks compliance performance metrics.

Requirements

Bachelor’s level degree in business, health administration, or a related field, a law degree, or an equivalent combination of education & experience.
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.
Must possess a thorough understanding and knowledge of health care legal and regulatory practices, financial and internal control systems/procedures.
Previous project, program, supervisory or management experience.
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.

Nice To Haves

Experience within a health care organization (including ambulatory and hospital settings) or equivalent work experience involving clinical documentation and coding reviews and working knowledge of Conditions of Payment including government and third-party payer regulations.
Must understand and have expertise with Patient Driven Payment Models, Patient Driven Groupings Models, IRF-PAI and OASIS requirements.
Comprehensive understanding of Medicare Physician Fee Schedule and Medicare Claims Processing Manual for professional services.
Comprehensive understanding of Conditions of Participation and Accreditation Standards.
CHC, CHPC, CHRC, CCEP or equivalent certification.
Lean/Six Sigma training and/or certification

Responsibilities

Assist the Integrity and Compliance Director with guiding and managing the compliance activities and initiatives for assigned ministry(ies).
Provides advice, guidance and program management to ministry leaders in developing, implementing and attaining program goals while ensuring alignment to compliance strategies.
Conducts investigations for local ministry and provides recommended action in response to outcome of investigation.
Participates in Service Area and Enterprise Integrity and Compliance projects with a focus on standardization and process improvements.
Support the Integrity and Compliance Director in developing, executing, and overseeing compliance initiatives within the ministry.
Provide expert advice and strategic guidance to ministry leaders on program goals and compliance strategies.
Lead and conduct internal investigations related to compliance concerns, ensuring thorough, timely, and objective outcomes.
Deliver well-documented recommendations for corrective actions based on investigative findings.
Partner with leaders across local ministries and enterprise functions to implement and sustain compliance strategies.
Actively participate in Service Area and Enterprise-level compliance projects, focusing on process improvement and standardization.
Collaborate on the development and rollout of organization-wide policies, training, and communication tools to foster a culture of ethics and compliance.
Monitor emerging risk areas and regulatory changes, ensuring proactive and appropriate organizational response.
Contribute to audit readiness activities and help strengthen internal controls across the ministry.
Track compliance performance metrics and support continuous improvement initiatives to enhance overall program effectiveness.