Bachelor's degree required; Master's preferred in Health Administration or Business Administration.
Experience managing healthcare operations or patient outreach programs.
Proven track record in managing third-party vendors and performance oversight.
Familiarity with medical billing and revenue cycle operations, especially related to AWV.
Strong leadership skills with experience managing teams of 25+ staff.
Proficient in data analysis and performance metrics reporting.
Knowledge of AWV, preventive care programs, and CMS billing guidelines.
Responsibilities
Review and optimize AWV schedules for provider appointment utilization.
Oversee daily outreach operations to meet scheduling goals.
Identify and address scheduling gaps to enhance patient access.
Collaborate with providers to align scheduling with patient demand.
Ensure compliance with organizational policies and healthcare regulations.
Manage and develop a team of 35-40 outreach and scheduling staff.
Oversee vendor relationships and monitor performance against service levels.
Benefits
Full-time remote position operating in PST.
Opportunity to lead and develop a high-performing team.
Engagement in meaningful work that improves health outcomes.
Access to professional development and training resources.
Full Job Description
Manager - Annual Wellness Visit Programs
Department: Quality - Risk Adjustment
Employment Type: Full Time
Location: 1600 Corporate Center Dr., Monterey Park, CA 91754
Reporting To: Nallammai Vijayakumar
Compensation: $85,000 - $119,000 / year
Description
The Manager - Annual Wellness Visit (AWV) Programs plays a vital role in helping members access preventive care that improves health outcomes. This leader oversees outreach, scheduling, billing, and vendor operations while partnering across the organization to maximize AWV completion rates, enhance patient engagement, and support quality initiatives. Success in this role comes from strong leadership, operational expertise, and a passion for developing high-performing teams.
What You'll Do
Program Operations
Review and monitor AWV schedules for providers to ensure optimal appointment utilization and access.
Oversee daily outreach operations to support Annual Wellness Visit scheduling goals.
Identify scheduling gaps and implement strategies to improve appointment volume and patient access.
Collaborate with providers and operational leadership to align scheduling capacity with patient demand.
Ensure outreach workflows comply with organizational policies and applicable healthcare regulations.
Troubleshoot day-to-day operational issues and escalate as needed.
Leadership & Team Management
Manage, coach, and oversee a team of approximately 35-40 outreach and scheduling staff.
Conduct candidate interviews and participate in hiring decisions.
Lead new hire onboarding, training, and ongoing staff development.
Monitor employee performance and provide regular feedback, coaching, and corrective action as needed.
Conduct and facilitate biweekly team meetings to communicate goals, updates, and performance expectations.
Develop and maintain training materials and standard operating procedures (SOPs) for outreach and scheduling staff.
Foster a collaborative, productive, and patient-centered work environment.
Manage staffing levels, scheduling, and coverage to ensure consistent operational support.
Vendor Management
Oversee relationships with third-party vendors supporting AWV scheduling and outreach functions.
Serve as primary point of contact for vendor partners, managing day-to-day communication and escalations.
Monitor vendor performance against contracted service levels (SLAs), including scheduling volume, quality, and turnaround times.
Review vendor productivity and outreach outcomes; hold vendors accountable to performance benchmarks.
Conduct regular vendor performance reviews and business updates to assess effectiveness and address gaps.
Coordinate between internal staff and vendor teams to ensure seamless scheduling coverage and consistent patient communication.
Billing Oversight
Oversee the end-to-end billing operations related to Annual Wellness Visits, ensuring accuracy, completeness, and timeliness of claims submission.
Monitor AWV coding and documentation practices to ensure compliance with CMS guidelines and payer requirements.
Track key billing metrics, including claims submitted, denial rates, reimbursement turnaround, and outstanding/unbilled visits.
Ensure proper reconciliation between completed AWV visits and billed/submitted claims.
Stay current on CMS and payer policy changes affecting AWV billing and communicate updates to relevant staff.
Performance Monitoring & Analytics
Track and analyze scheduling, outreach, vendor, and billing metrics, including:
Total outreach attempts (internal and vendor)
Total appointments scheduled
Individual team member and vendor productivity
Team and vendor performance trends
AWV completion rates (YTD)
Develop and maintain reports that measure outreach effectiveness, operational performance, vendor outcomes, and billing performance.
Create executive-level reports and dashboards highlighting program outcomes, productivity, revenue impact, vendor performance, and KPIs.
Identify trends and opportunities for process improvement through data analysis across operations, vendor performance, and billing.
Stakeholder Collaboration & Communication
Meet weekly with leadership to review program performance, vendor performance, billing status, challenges, and strategic initiatives.
Provide recommendations to improve outreach efficiencies, scheduling workflows, vendor utilization, billing accuracy, and patient engagement efforts.
Communicate program results and operational updates to management, providers, and cross-functional stakeholders (finance, compliance, revenue cycle, procurement).
Serve as a liaison between internal outreach/scheduling teams, vendor partners, and billing/revenue cycle teams to ensure alignment.
Qualifications
Bachelor's degree required; Master's degree in Health Administration, Business Administration, or related field preferred.
Experience managing healthcare operations, patient outreach programs, or care coordination teams.
Experience managing third-party vendors or outsourced service partners, including SLA management and performance oversight.
Experience overseeing or working closely with medical billing/revenue cycle operations, preferably related to AWV or preventive care services.
Strong leadership and team management skills, including experience managing teams of 25+ staff.
Experience with reporting, data analysis, and performance metrics.
Knowledge of AWV, preventive care programs, CMS billing guidelines, and healthcare scheduling workflows.
Proficiency in Microsoft Excel, reporting/BI tools, and healthcare management/billing systems.
Strong organizational, communication, negotiation, and problem-solving skills.
Environmental Job Requirements and Working Conditions
This is a full-time, remote position that operates in PST.
The total compensation target pay range for this role is: $85,000 - $115,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
