Program Manager – Remote Patient Monitoring (RPM)

Responsibilities

• Operate day-to-day RPM program, developing and standardizing workflows.
• Coordinate between providers, care coordinators, IT, and RCM teams for efficient operations.
• Build scalable processes to support enrollment growth.
• Maintain financial oversight, monitoring monthly RPM enrollment, billing, and reimbursement performance.
• Ensure compliance with CMS guidelines for CPT billing requirements.
• Partner with Revenue Cycle Management to reduce denials and optimize billing capture.
• Track program margin and identify operational inefficiencies.
• Present weekly performance dashboards to leadership.
• Own and manage performance metrics such as patient transmission adherence, monthly billing capture rate, documentation error rate, and response time for abnormal clinical alerts.
• Supervise RPM Care Coordinators, conducting productivity monitoring and performance evaluations.
• Foster a culture of accountability, collaboration, and continuous improvement.
• Ensure RPM services comply with Medicare, Medicaid, and HIPAA regulations.
• Conduct routine audits of documentation and workflow adherence.
• Collaborate with providers to ensure appropriate clinical interventions based on RPM alerts.
• Maintain high standards of patient safety and quality of care.
• Oversee RPM device vendors and platform performance, ensuring seamless EHR integration and data accuracy.
• Collaborate with IT to troubleshoot connectivity or transmission issues.
• Evaluate new RPM technologies and recommend system improvements.
• Develop strategies to improve patient retention and adherence.
• Ensure patients receive proper education and support for device usage.
• Address barriers to participation and improve satisfaction metrics.

Qualifications

• Required: Bachelor’s degree in Healthcare Administration or related field, 3-5 years of clinical or care management experience, minimum 2-3 years of healthcare leadership experience, experience with Remote Patient Monitoring or telehealth programs, knowledge of CMS billing requirements and compliance standards, experience using EHR systems and healthcare analytics tools.
• PREFERRED: Master’s degree (MHA, MBA, MSN, or related field), certification in Case Management (CCM), certification in Healthcare Information Systems (CPHIMS), experience in population health or value-based care programs.

Key Competencies

• Strong operational and financial acumen.
• Data-driven decision-making.
• Expertise in CMS and HIPAA compliance.
• Ability to translate analytics into workflow improvements.
• Excellent leadership and communication skills.
• High level of organizational accountability.