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

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What You'll Do

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.