Care Manager

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.