CenterWell Senior Primary Care

QA Engineer

• consults and collaborates with clinicians to ensure high accountability of compliance and quality
• provides guidance to branch and branch leadership with strategy for ongoing performance improvement and quality assurance initiatives
• provides instructor lead education, training, and coaching to field staff, case managers
• completes chart auditing and data collection with instructor lead feedback and support to ensure regulatory compliance
• monitors quality investigations and compliance processes

Quality Assurance, Clinical Professional 2

Therapist

• Plan and administer prescribed physical therapy treatment for patients, working onsite in their homes, to attain highest level of physical function.
• Assess and document patients' physical strengths to support physician evaluation and guide treatment goals.
• Develop and implement a rehabilitation program consistent with physician's Plan of Treatment and the goals of the patient team.
• Provide PTAs and Home Health Aides with clear written care instructions and oversee their performance and documentation.
• Document patient observations, interventions, and evaluations promptly and thoroughly.
• Report patient progress to the physician, Clinical Manager, care team, patient, and family, and submit all required evaluations, plans, progress notes, and discharge summaries.

Home Health Physical Therapist

Sales

• Conducts selling activities within a primary care setting
• Makes 45 outbound calls per day with the goal of getting patients back into clinics
• Re-engages Medicare eligible patients through telephonic conversations
• Proactively anticipates patients' needs in order to provide guidance and customer service
• Documents and modifies contact notes across multiple systems as necessary

Bilingual Outbound Tele Sales Agent

• Provide therapy services planned, delegated and supervised by the qualified Occupational Therapist in accordance with the patient's Plan of Treatment.
• Assist in the implementation of vocational/education programs and activities established by registered Occupational Therapist.
• Design/adapt equipment and working and/or living environment.
• Provide therapeutic treatment and instruction to patients as directed by the qualified Occupational Therapist.
• Report information and observations to Occupational Therapist and/or Clinical supervisor.
• Maintain and submit documentation as required by the Company and/or facility.
• Instruct patients and family members regarding home programs as well as care and use of adaptive equipment.
• Participate in care coordination and discharge planning activities.

Occupational Therapist Assistant

Director

• responsible for administration and/or management of branches
• oversee private pay, in home, or certified home health branches
• make decisions related to complex technical and operational problems

Branch Director – Home Health

Administration

• Contributes to administration of utilization management
• Works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems
• Receives assignments in the form of goals and determines approach, resources, schedules, and goals
• Provides non-clinical support for the procedures ensuring best treatment, care or services for members
• Makes decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area
• Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department

Manager, UM Administration

• Plan and administer prescribed physical therapy treatment for patients
• Assess and document patients' physical strengths
• Develop and implement a rehabilitation program
• Provide PTAs and Home Health Aides with care instructions
• Document patient observations, interventions, and evaluations
• Report patient progress to the physician and care team

Manager

• Oversee the review, adjudication, and resolution of home health, DME, home infusion and SNF claims, including Medicare, Medicaid, and commercial payer claims, ensuring compliance with payer guidelines, CMS regulations, and organizational policies.
• Determine whether claims are paid, denied, returned, or adjusted based on clinical documentation, coding accuracy, authorization status, and payer requirements.
• Manage escalated, complex, or high-risk claims issues, including denials, underpayments, and payer disputes.
• Manage and develop claims processing professionals and/or claims supervisors; set performance expectations, provide coaching, and conduct performance reviews.
• Identify, lead, and implement change initiatives to improve claims processing efficiency, denial rates, turnaround times, and cash flow.
• Collaborate with Coding, Clinical Operations, Intake, Authorization, Finance, and Compliance teams to ensure accurate documentation and clean claim submission.

Quality Assurance, Clinical Professional 2

Home Health Physical Therapist

Bilingual Outbound Tele Sales Agent

Occupational Therapist Assistant

Branch Director – Home Health

Manager, UM Administration

Home Health Physical Therapist

Manager, Claims Processing