Program Manager - HealthCare

The PCM (Principal Care Management) Program Manager, who is also a Licensed Practical Nurse (LPN), Certified Medical Assistant (CMA/RMA) or higher, is responsible for managing and coordinating patient care across multiple healthcare settings. This role involves working closely with patients and healthcare providers to ensure that patients receive comprehensive and continuous care. The Care Manager utilizes clinical knowledge and skills to assist with patient needs, develop care plans, and facilitate communication between patients and healthcare providers.

The PCM Manager is also responsible for the day-to-day management of the PCM team/PCM coordinators. This includes running reports, assigning patients, data tracking, managing timesheets/PTO, performance reviews/disciplinary action, and training new employees. The PCM Manager will report directly to the Care Management department head and will be responsible for developing, tracking, and reporting on the KPIs of the PCM team. The PCM manager must be able to adapt to the needs of a growing and changing program, must have excellent organizational, time management skills, and communication skills. Must be able to work independently. Previous supervisor/management experience is preferred.

Care Coordination:

• Collaborate with healthcare providers to develop and implement individualized care plans for patients.
• Monitor patient progress and provide feedback to physicians to adjust care plans as needed to ensure optimal health outcomes.
• Coordinate and facilitate referrals to specialists, diagnostic testing, and other healthcare services.
• Ensure that patients have access to necessary medical resources and support services.

Patient Interaction:

• Educate patients and their families about their health conditions, treatment options, and care management strategies.
• Conduct regular follow-up calls or visits to monitor patient status and adherence to care plans.
• Assist patients with scheduling appointments and navigating the healthcare system.

Clinical Support:

• Assist in managing chronic conditions by monitoring symptoms and coordinating care with healthcare providers.
• Maintain accurate and up-to-date patient records, including documenting all patient interactions and care plans in the electronic health record (EHR) system.
• Participate in multidisciplinary care team meetings to discuss patient progress and coordinate care efforts.

Administrative Duties:

• Coordinate communication between patients, healthcare providers, and insurance companies to ensure that care is delivered efficiently and effectively.
• Track patient outcomes and report on the effectiveness of care plans to the care management team.
• Maintain compliance with all relevant regulations, including HIPAA, and ensure patient confidentiality.
• Assign newly enrolled PCM patients to PCM coordinators
• Develop and track team KPIs and report to department head
• Track and report status/progress of the PCM program
• Work with/assist practices and staff to develop internal workflows for PCM
• Develop and implement team training, new employee training, performance reviews
• Create forecasts and track Revenue of PCM Program
• Other duties/assignments assigned by Head of Care Management

Benefits

• Our company offers a comprehensive benefit package, including health insurance, Dental and vision.

Qualifications

• License or certification: LPN or CMA or higher, or relevant experience, CCM certified or Care Management experience is a plus but not required.
• Years of experience preferred: 5+ years with at least 1-2 years of those in a management or supervisor role
• Software / systems needed: Excellent skills with Microsoft office/365 specifically Excel and Power BI

Physical Demands

• Sit for long periods of time / Long periods of time on the phone

Working Conditions

• Hybrid position working both in clinics and remotely. Some travel required

Supervisory Responsibility

• This is a manager position- will manage a growing team and report to department head

Job Types: Full-time, Permanent

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Experience:

• Program management: 3 years (Required)

License/Certification:

• LPN / CMA / CCM certified or Care Management Certification (Required)

Willingness to travel:

• 25% (Required)

Work Location: Remote