Chronic Care Management Program Lead, Fee for Service

🕒 October 21

🇺🇸 United States – Remote

💵 $110k - $120k / year

⏰ Full Time

🟠 Senior

📋 Program Manager

👻 Ghost score 2%

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• Open for 22 days.
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Diverge Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🌍 Social Impact

Healthcare • Healthcare Insurance • Social Impact

Diverge Health is a company dedicated to empowering primary care practices to deliver the highest quality care to underserved patients. The company provides infrastructure support to primary care providers, including highly trained community health teams, administrative aids, and technology solutions for local population health management. Diverge Health aims to enhance healthcare outcomes and assist practices in transitioning to value-based payment models. The company grew its foundation by acquiring the intellectual property of City Health Works, focusing on deploying trusted community health workers to assist patients in effectively managing care and reducing complications. Diverge Health plays a pivotal role in improving primary care delivery, patient health literacy, and providing better financial performance and provider satisfaction for payors.

📋 Description

• Support Practice Liaisons during health center pitches by answering detailed clinical and billing questions • Own onboarding of newly signed health centers with Practice Liaisons, translating the fee-for-service model into practical implementation steps • Serve as the tactical subject matter expert for day-to-day fee-for-service care management delivery • Troubleshoot health center billing issues by tracing root causes in documentation or workflows • Build and maintain FAQs and training materials • Scale expertise across the fee-for-service portfolio by training trainers

🎯 Requirements

• Registered Nurse (RN) license in good standing, or equivalent clinical licensure • 5 to 10 years of experience in fee for service chronic care management, transitions of care, or advanced primary care, including hands-on experience across the full workflow: care plan development, medication reconciliation, EMR documentation, and billing • Experience working within or supporting Federally Qualified Health Centers (FQHCs) or similar community-based healthcare settings • Demonstrated ability to trace a billing issue back to the documentation or process step that caused it • Comfort fielding detailed, state specific and payer specific questions from health center staff • Experience training or onboarding new staff or partner organizations on a clinical workflow • Familiarity with value-based care models and population health strategies • Certification in Case Management (CCM), APCM, ToC and CoCM (preferred) • Candidates must be authorized to work in the United States without the need for employer sponsorship, now or at any time in the future • Candidates must be able to work outside Alaska and Hawaii

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