Program Manager, Recuperative Care (4794)

Position Summary


The Program Manager plays a central role in supporting patient flow, access to care, and service coordination within the Recuperative Care program. This position is responsible for developing and managing referral pipelines, coordinating admissions and discharges, supporting authorization processes, and optimizing provider scheduling to ensure timely, equitable, and high-quality care.


Working collaboratively across clinical, case management, and external partner teams, the Program Manager helps ensure that patients experience smooth transitions into and out of care, while supporting the program's goals of high bed utilization, strong care engagement, and continuity of services.


Essential Functions:


1. Referral Development & Partner Engagement

• Build and maintain collaborative relationships with referral partners, including hospitals, street-based teams, managed care plans, and community providers

• Conduct outreach and provide education on program eligibility, referral processes, and service offerings

• Develop and maintain systems to track referral sources, volume, and outcomes

• Monitor referral trends and partner engagement, and support strategies to create effective and consistent referral pipelines

• Provide timely and respectful communication to referral partners regarding referral status and decisions

2. Intake Coordination & Eligibility Determination

• Review and screen referrals to assess eligibility based on program criteria, clinical needs, and payer requirements

• Coordinate with referral partners to obtain necessary documentation in a timely and organized manner

• Troubleshoot insurance eligibility and enrollment issues, collaborating with internal and external stakeholders as needed

• Communicate intake decisions clearly and compassionately to referral partners

• Maintain organized records of referrals, determinations, and supporting documentation

3. Authorization & Appeals Management

• Coordinate authorization requests with managed care plans and other payers

• Compile required medical documentation and develop clear, concise clinical summaries to support authorization requests

• Monitor authorization status and follow up to minimize delays in care access

• Facilitate appeals for denied services, including gathering supporting documentation and coordinating resubmissions

• Track authorization outcomes and identify trends to inform process improvements

4. Census Management & Bed Throughput

• Maintain real-time awareness of program census, bed availability, and anticipated discharges

• Coordinate admissions and discharges to support continuous bed utilization and minimize vacancy time

• Collaborate with care teams to anticipate discharge timelines and align incoming admissions

• Support development and maintenance of systems to track bed utilization, length of stay, and throughput metrics

• Assist with coordination of logistics related to admissions and discharges, including timing and communication

• Assist with entering billing charges into Electronic Health Record

5. Internal Care Coordination & Discharge Support

• Partner with nursing, case management, and behavioral health staff to prepare for patient admissions and discharges

• Support care teams in addressing barriers that may impact successful engagement or contribute to early or unplanned discharges

• Participate in team meetings and case coordination efforts as appropriate

• Help ensure that transitions into and out of the program are well-coordinated, patient-centered, and trauma-informed

6. Provider Scheduling & Template Management

• Coordinate scheduling of medical and behavioral health provider visits for patients

• Maintain and update provider schedule templates within Epic or other scheduling systems

• Manage provider calendars, including adjustments, cancellations, and coverage coordination

• Proactively fill open appointment slots to support timely access to care and achievement of visit targets

• Coordinate rescheduling as needed to ensure continuity of care

7. Patient Engagement & Visit Coordination

• Monitor completion of scheduled provider visits and support follow-up on missed or rescheduled appointments

• Collaborate with care teams to address barriers to patient engagement in services

• Generate and share regular reports on visit completion and engagement trends

• Support workflows that promote consistent and equitable access to care for all patients

8. Data Tracking, Reporting & Quality Improvement

• Maintain accurate and up-to-date tracking systems related to referrals, admissions, authorizations, and visit completion

• Prepare routine and ad hoc reports to support program monitoring and decision-making

• Identify trends and opportunities for workflow improvements in coordination with program leadership

• Support quality improvement initiatives and compliance with program requirements

Qualifications


Required:

• Bachelor's or Associate's degree in health administration, social services, public health, or a related field

• Minimum of 2-3 years of experience in healthcare, homeless services, care coordination, or a related setting

• Experience coordinating across multiple teams and managing complex patient care workflows

• Strong organizational skills and attention to detail

• Ability to communicate effectively and respectfully with diverse stakeholders, including patients, providers, and external partners

• Comfort working with electronic systems and data tracking tools

Preferred:

• Experience as a Certified Nursing Assistant, Licensed Vocational Nurse, or Medical Assistant

• Experience in recuperative care, post-acute care, or community-based healthcare programs

• Familiarity with managed care, Medi-Cal/Medicaid, or authorization processes

• Experience using Epic or similar electronic health record systems

• Experience supporting quality improvement or performance tracking initiatives

Core Competencies

• Coordination & Systems Thinking: Ability to manage multiple processes simultaneously while understanding how they impact overall program flow

• Relationship Building: Demonstrates a collaborative, respectful approach to working with internal teams and external partners

• Equity & Trauma-Informed Practice: Approaches all interactions with cultural humility, empathy, and an understanding of the impact of trauma

• Problem Solving: Identifies barriers and works proactively to develop practical, patient-centered solutions

• Adaptability: Navigates changing priorities and operational needs with flexibility

Working Conditions

• Primarily office-based within a clinical program setting, with regular interaction across care teams

• May require occasional travel to partner sites or participation in external meetings

• Work may involve managing multiple priorities in a fast-paced environment