1. Identify, analyze and streamline referral/data entry processes, insurance verifications, authorizations for both Hospice and Home Health.
2. Provide direct operational and supervisory oversight of hospital liaisons supporting home health and hospice referral sources.
3. Serve as the primary operational point of escalation for hospital partners regarding referral issues, admission barriers, coverage concerns, and service availability.
4. Collaborate with hospital case management, liaisons, and physicians to strengthen referral relationships, to improve referrals and home health and hospice census.
5. Manage insurance benefits in the best interest of the agency and patients including resolving authorization and coverage issues. 
6. Problem-solve complex authorization, payer and referral challenges to minimize delays in care.
7. Develop, implement and maintain standardized work processes within assigned departments to ensure efficiency, accuracy and consistency.
8. Establishment of departmental performance metrics and tracking systems’ monitor outcomes and identify opportunities for improvement for all assigned departments.
9. Conducts interviews and, hires and oversees on-boarding and orientation of new staff.
10. Conduct ongoing coaching, training and annual timely employee performance evaluations for assigned staff.
11. Manage PTO requests and staff schedules to ensure adequate coverage and operational continuity. 
12. Educates staff on regulatory changes, workflow changes and organizational policies and procedures for Hospice and Home Health.
13. Conducts monthly staff meetings and weekly team huddles with assigned departments to support communication, accountability and performance.
14. Serves as a subject matter expert with e-discharge systems, insurance portals, electronic medical record (EMR) systems.
15. Act as primary resource and point of contact for referral sources and insurance providers for both Hospice and Home Health.
16. Provide onsite operational coverage as needed during staffing shortages including phones, faxes, electronic systems, referral entry and obtaining verification or authorization of insurance benefit
17. Communicate effectively with internal departments and Team Managers regarding referrals, availability of services, insurance benefit and authorization, scheduling and data entry issues
18. Maintain Alerts Reports in EMR to manage “NTUC” volume
19. Challenges current working practices; identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.
20. Other duties as assigned

• Bachelor’s Degree in a clinical field preferred but not required
• Two years’ healthcare management experience preferred
• Two years’ experience in homecare operations preferred
• In-depth knowledge of disease management, financial and insurance reimbursement
• Understanding of Home Health and Hospice regulatory requirements
• Familiarity with electronic discharge management systems and EMR

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Pay Range Details

The pay range displayed on each job posting reflects the anticipated range for new hires. A successful candidate’s actual compensation will be determined after taking factors into consideration such as the candidate’s work history, experience, skill set, and education. This is not inclusive of the value of Cape Cod Healthcare’s benefits package (if applicable), which includes among other benefits, healthcare/dental/vision and retirement. For annual salaries this is based on full-time employment.

Beware scam interview requests

Cape Cod Healthcare has been made aware of an instance in which a potential scammer has attempted to impersonate CCHC leadership and request chat interviews. Please note this is not our process and we will never direct you to interview solely through web-based chat. For any questions about available job opportunities or to learn more about our interview process please visit our careers page: https://www.capecodhealth.org/careers/