Annual Wellness Visit Programs Leader

Astrana Health Management; Monterey Park (CA); Híbrido; USD 85.000 - 119.000; Jornada completa

Descripción de la vacante

Astrana Health Management is seeking a Manager for Contact Center Operations and AWV Programs. This remote, full-time role leads program operations, vendor management, and billing oversight to improve AWV completion rates and patient engagement.

Reporting to the Quality - Risk Adjustment leader, you will supervise a 35–40 person team, collaborate with providers and leadership, and drive data-driven improvements in scheduling, outreach, and billing processes.

Formación

• Experience managing healthcare operations or care coordination teams.
• Experience managing third-party vendors with SLA oversight.
• Experience overseeing medical billing/revenue cycle, preferably AWV or preventive care.
• Strong leadership and team management skills, including 25+ staff.
• Proficiency with Excel and reporting/BI tools.

Responsabilidades

• Oversee AWV outreach scheduling and vendor operations to maximize completion rates.
• Lead a 35–40 person outreach and scheduling team; conduct hiring and onboarding.
• Manage end-to-end AWV billing and ensure CMS compliance.
• Develop reports and dashboards to track KPIs and program impact.
• Collaborate with leadership and stakeholders to align operations with strategy.

Conocimientos

Leadership

Team management

Communication

Problem-solving

Data analysis

Educación

Bachelor's degree

Master's degree preferred

Herramientas

Microsoft Excel

Reporting/BI tools

Billing systems

Healthcare management systems

Descripción del empleo

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

Astrana Health is seeking a results-driven Manager, Annual Wellness Visit (AWV) Programs to oversee the day-to-day operations of our AWV scheduling and billing functions. This role is responsible for leading a team of supervisors, patient engagement specialists, and billing professionals, while managing external vendor partnerships to ensure efficient scheduling, consistent member outreach, and timely billing and submission of completed visits.

The Manager will play a critical role in driving AWV program performance by establishing clear expectations, monitoring productivity and quality metrics, and ensuring the team consistently meets operational goals. Working closely with our Nurse Practitioner (NP) team and cross-functional partners, this individual will help maximize appointment completion rates and ensure providers have the scheduled visits needed to support program success.

The ideal candidate is an experienced people leader with a background in call center operations, patient engagement, scheduling, or healthcare operations. They are comfortable managing multiple teams and vendor relationships, using data to monitor performance, and holding teams accountable to established standards. Success in this role requires a hands-on leadership approach, strong communication skills, and the ability to maintain a positive team culture while driving productivity, quality, and operational efficiency.

Our Values:

• 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.
• Other duties as assigned.

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.