What are the responsibilities and job description for the GUIDE Compliance & Program Manager position at Pathways Health Partners, LLC?
Welcome to Pathways Health Partners, the Accountable Care Organization (ACO) that's leading the charge in helping independent providers transition to Value-Based Care.
What We Do:
Medicare REACH ACO: We're at the forefront of Medicare innovation.
Medicare Advantage MSO: Providing top-notch services to our Medicare Advantage patients.
Commercial MSO: Managing care for approximately 16,000 patients across North-West/Central Florida.
Where We Operate: From The Villages to St. Petersburg, and across to Mount Dora, we've got you covered!
Our Services:
Hospital Medicine Group: Delivering exceptional care in hospitals.
Affiliated Medical Practices: Managing several top-tier medical practices.
Insurance Agency: Offering comprehensive insurance solutions.
Join us on our journey to better health and value-based care!
Job Summary
The GUIDE Compliance and Program Manager assures all necessary CMS compliance for GUIDE program, contracts practitioners to join GUIDE Roster, contracts organizations for respite services, contracts organizations for home health partnerships. Attends marketing events, supports the fundamentals of the GUIDE program which is improving caregiver support, patient/caregiver education on Dementia, keeping patients home as long and safe as possible.
Role and Responsibilities
- CMS Compliance of GUIDE program
- Maintain CMS Portal. Ie Participant & Organizations roster, addresses
- Submit PAAF Excel spreadsheet in portal
- Retrieval from portal alignment/unalignment/declined reports bi-weekly
- Retrieval from portal payment reports
- Complete weekly, monthly, quarterly and annual reports and surveys as required
- Contracts organizations for Respite Partners (In Home respite, Day stay programs, and 24-hour overnight facilities).
Qualifications/Position Requirements:
1. Education: Bachelor's Degree
2. Experience: Minimum of 2 years of experience in management, understanding of compliance, or a related role within a healthcare setting.
3. Certification/Licensure: Valid Florida Driver License (unencumbered and no points)
4. Training and Knowledge Required at Time of Hire: Excellent computer skills with experience in Outlook, MS Office Suite, EMRs; positive and effective communication skills; Good typing skills.
Why Work for Pathways?
Pathways Health Partners is a growing company based in Leesburg, FL. We are proud of our professional yet family culture with the executive team working daily alongside our team members. We provide competitive salaries, bonuses for all team members, and a benefits package that is second to none.
- Medical Insurance for Employee and Spouse/Significant Other paid up to 100% by Pathways!
- Addition of family coverage for dependents at a fraction of the cost
- 25K life insurance for employees 100% paid by Pathways!
- Increasing Employee coverage or adding spouse/dependents at a fraction of the cost
- Vision and Dental Coverage available at a very low cost for employees, spouses, and family
- 401K retirement plan with 100% match up to 4% of annual pay
- Paid holidays
- Ample Paid Time Off (PTO) for vacation/sick/personal days
We look forward to speaking with you about this opportunity!
Salary : $50,881 - $78,327