Program Manager

Main Duties

• Main contact for insurance vendors and providers and face to face meetings with their management staff
• Manages and directs the day-to-day operations of the clinical program on a daily basis
• Provides oversight of midlevel providers including chart review, management of staff, and coordination of the delivery of patient care in the program
• Maintains knowledge and adheres to all company policies and procedures and regulatory standards
• Participates in the development of the clinical strategic and operational plans and provides leadership needed to achieve medical goals

Qualifications

• Comprehensive knowledge of general nursing theory, technique and practice
• Ability to accurately perform physical assessment and obtain a health history and develop therapeutic and teaching plans
• Ability to independently plan a personal work schedule and work to complete the assignment on a timely basis
• Ability to communicate effectively, verbally and in writing

Functions & Responsibilities

• Completes timely reports and coordinates with insurance companies for approval and authorization
• Has the ability to perform complete nursing assessment including head to toe physical assessments as needed
• Provides regular communication with the staff regarding pertinent organizational and clinical issues
• Investigates problems, grievances and complaints and takes and active role in corrective action
• Implements and evaluates the plan of care in conjunction with Registered Nurse and physician
• Maintains continuity of care throughout the program
• Maintains continuing education through academic studies, seminars, and workshops
• Plans and implements clinical training for field staff and develops education program in accordance with the Clinical Educator
• Communicates with all members of the multidisciplinary team to improve the quality of patient care
• Participates in patient care conferences and makes regular entries inpatient care logs
• Completes case conference documentation for each patient on the nursing care team
• Reports patient’s response to treatment accurately
• Appropriately identifies progress or lack of progress in the Plan of Treatment and the appropriate nursing action based on patient response