Job Description

Position Summary:

Suma Home Health Care is seeking a highly organized, detail-oriented, and compassionate Care Manager to join our dynamic team. This pivotal role is responsible for the end-to-end management of client care, ensuring service authorization compliance, coordinating staff schedules, and managing critical administrative functions including EVV, billing, and payroll. The ideal candidate will be a proactive problem-solver with excellent communication skills and a deep commitment to client and employee satisfaction.

Key Responsibilities:

Client Management:

Act as the primary point of contact for clients and their families, addressing inquiries and concerns with empathy and professionalism. Coordinate with healthcare professionals, including nurses and therapists, to ensure a multidisciplinary approach to client care. Monitor client progress and make necessary adjustments to care plans to meet evolving needs.

Authorization & Compliance:

Verify and track insurance authorizations for both skilled and non-skilled services. Ensure all services provided are within the authorized scope and timeframe. Proactively manage re-authorization processes to prevent gaps in client care.

Scheduling & Coordination:

Create and manage efficient staff schedules to ensure all client shifts are filled appropriately. Match client needs with caregiver skills and availability. Handle schedule changes, call-offs, and urgent staffing needs in a timely manner.

EVV (Electronic Visit Verification) Management:

Oversee the implementation and compliance of the EVV system for all field staff. Train caregivers on proper EVV clock-in/clock-out procedures using the Kantime system. Verify and approve EVV visits daily, addressing any discrepancies or missed punches promptly. Ensure EVV data is accurately captured for billing and payroll purposes.

Incident Reporting:

Serve as the point of contact for all incident reports (e.g., client falls, medication errors, employee injuries). Document incidents thoroughly and accurately within the Kantime system and HHAExchange. Follow established protocols for investigation, reporting to appropriate agencies as required, and implementing corrective actions.

Billing & Payroll Support:

Work closely with the billing department to ensure EVV data is accurately translated into client invoices. Review and verify hours in Kantime for payroll processing. Resolve any billing or payroll discrepancies related to client services or caregiver hours.

Administrative & Technology:

Maintain accurate and up-to-date client and employee records in the Kantime system. Generate reports on client care, staff hours, and authorization status as needed. Utilize Kantime proficiently for all aspects of care management.

Qualifications & Skills:

Required:

+ Proven experience (2+ years) in a care management, scheduling, or client services role within a home health care setting.
+ Demonstrated experience with

Kantime

software is highly preferred.
+ Understanding of insurance verification and authorization processes for skilled and non-skilled services.
+ Experience managing EVV systems and ensuring compliance.
+ Strong knowledge of billing and payroll processes in a healthcare context.
+ Excellent verbal and written communication skills, with the ability to interact effectively with clients, families, caregivers, and healthcare professionals.
+ Exceptional organizational, time-management, and problem-solving skills.
+ High level of proficiency with computers and software applications.

Preferred:

+ Associate's or Bachelor's degree in Healthcare Administration, Nursing, Social Work, or a related field.
+ Certification as a Home Care Manager is a plus.