Program Manager

Passion To Care IN -

Job Summary

The Home Health Program Manager will be responsible for  for the management and coordination of home health services for clients within the community. This includes overseeing, sourcing, attracting, and managing high volumes of qualified leads (Calls), overseeing the full new start process from start to finish. This role also includes tracking metrics, conducting interviews, negotiating pay rates, and providing onboarding support, while ensuring a positive candidate experience and regularly traveling within the territory to meet with clients and prospects.

Duties / Responsibilities :

• Source and Attract Candidates : Proactively identify, source, and engage high volumes of qualified candidates through job boards, social media, referrals, and other channels.
• Build and Maintain Pipelines : Develop and maintain a pipeline of leads to meet the ongoing needs of the organization, focusing on both current and future hiring demands.
• Manage High Volumes : Efficiently manage multiple authorization requests simultaneously, ensuring timely processing to avoid delays in client care.
• Foster a Positive Candidate Experience : Ensure a seamless and professional experience for all candidates, from initial contact through onboarding, enhancing the employer brand.
• Travel within Territory : Regularly travel within the assigned sales territory to meet with clients and prospects, fostering face-to-face relationships and expanding business opportunities.
• Negotiate Pay Rates : Skillfully negotiate terms and conditions with prospective caregivers to close deals that align with company goals while ensuring customer satisfaction.
• Provide Onboarding Support : Collaborate with internal teams to ensure seamless delivery of new starts and provide ongoing support to resolve caregiver issues or concerns.
• Verify Insurance Coverage : Confirm patient eligibility, insurance benefits, and coverage limits for services prior to treatment.
• Obtain Authorizations : Secure prior authorizations and pre-certifications from insurance companies for procedures, treatments, and services to ensure reimbursement.
• Track Authorization Status : Monitor the status of pending authorizations, resolve delays, and follow up with payers to expedite approvals.
• Update Patient Records : Accurately document all interactions with payers, authorization approvals, denials, and related correspondence in the patient’s medical records or billing system.
• Communicate with Client : Inform clients about their insurance coverage, authorization requirements, and any out-of-pocket costs that may arise from denied services.
• Maintain Payer Relationships : Develop and nurture positive working relationships with insurance payers to ensure smooth interactions and resolve any issues regarding coverage or payments.
• Advocate for Clients and Company : Work to resolve payment and authorization issues that affect access to care, advocating on behalf of both the company and the client.
• Support Revenue Cycle Teams : Collaborate closely with billing, coding, and revenue cycle management teams to ensure efficient claims processing and resolve any payer-related bottlenecks.
Qualifications :
• Education :
• Bachelor’s degree in Nursing, Healthcare Administration, or a related field.
• Certification in healthcare management or related field preferred.
• Experience :
• At least 3-5 years of experience in healthcare management, with a focus on home health or similar settings.

This role requires a combination of clinical & non clinical knowledge, managerial skills, and a deep understanding of healthcare regulations and quality care practices. The Home Health Program Manager plays a key role in ensuring that home health services are delivered efficiently, effectively, and with compassion.