Physical Therapy Program Manager

Benefits include:

- Monday - Friday (No weekends and no holidays)

- Health, dental, and vision full coverage for individual - Family option available

- Short term/long term disability options

- Vacation (annual) + PTO (accrued weekly)

- 16 paid holidays in the calendar year

- 401K - 5% matching

- Parental, medical, education, bereavement leaves and so much more!

BASIC FUNCTION:

The Physical Therapy Program Manager is responsible for overseeing the day-to-day operations of the Physical Therapy program, including scheduling, prior authorizations, and referral management. This position ensures timely and compliant coordination of patient care, supports organizational goals related to throughput and access, and maintains efficient workflows between providers, ancillary departments, and payers. The Program Manager supports the Physical Therapy providers by reducing administrative burden and assisting in optimizing service capacity, patient satisfaction, and overall quality of care.

GENERAL RESPONSIBILITIES:

- Performs managerial support for the Physical Therapy Department and Chief Medical Officer (CMO), including the communication and assessment of program goals and measures, and key workflow measures.

- Oversees the maintenance of various files (leave requests, purchases requisitions, provider time sheets, non-licensed staff evaluations, quarterly reports, etc.) and performs related operational functions.

- Proficiency of current computer programs required for reports, scheduling, tracking referrals, authorizations, productivity and other daily operational functions.

- Performs support work on assigned projects initiation through completion, including special clinical events, patient access initiatives, and process improvement programs.

- Oversees scheduling and coordination of Physical Therapy appointments, including visit prioritization, visit-type optimization, and capacity utilization planning for providers.

- Manages referral workflows, ensuring accurate documentation and dissemination of relevant health information between SNHS providers, external specialists, and the SNHS Referrals Department. Ensures accuracy when coordinating offsite referrals to hospital settings and community providers.

- Obtains, tracks, and manages insurance prior authorizations for physical therapy services, communicating clinical needs, payer requirements, and authorization outcomes to providers and patients.

- Coordinates and verifies EHR data for accuracy to resolve discrepancies in collaboration with Billing to ensure proper third-party reimbursement and to prevent avoidable claim denials.

- Ensures that all patient information and records are maintained in accordance with HIPAA and SNHS patient privacy policies, and applicable accreditation standards.

- Upholds and promotes the value and integrity of the Seneca Nation Health System’s mission statement. Will promote SNHS in a positive manner.

- Provides care through a trauma-informed lens by incorporating key principles of both physical and psychological environment safety, trustworthiness and transparency, collaboration of decision-making during treatment plan developments, empowerment of patients by recognizing and building upon individual strengths, as well as recognizing and respecting the diversity of cultural backgrounds and sensitivity.

- Participates and completes all mandatory staff trainings and in-services, and maintaining all required competencies.

- Records and maintains meeting minutes and publishes a record of minutes for administration.

- Adheres to all policies and procedures of the department, Seneca Nation (SN) and SNHS.

- Works to promote cooperative staff efforts and seeks resolution of workplace conflicts at earliest stages.

- Tracks authorization timelines, expiration dates, and referral backlog, escalating risks to leadership when necessary.

- Identifies process improvement opportunities related to authorization workflows, scheduling templates, payer documentation requirements, and interdepartmental hand-offs.

- Generates operational metrics, productivity data, denial trends, and access reports as requested by leadership for ongoing quality improvement and accreditation readiness.

- Serves as primary liaison between Physical Therapy, Medical, Billing, and external specialists, reducing fragmentation of care.

KNOWLEDGE, SKILLS, & ABILITIES:

- Strong understanding of referral and prior authorizations workflows.

- Knowledge of Medicare, Medicaid, commercial insurance, and workers’ compensation regulations.

- Customer service skills appropriate to patients of all ages.

- Excellent computer, organizational, and interpersonal skills.

- Excellent professional phone etiquette.

- Working knowledge of physical therapy terminology, modalities, and frequency/authorization limits.

- Ability to interpret payer guidelines and communicate documentation requirements to providers.

- Ability to multitask effectively in a fast-paced clinical environment.

- Strong attention to detail with high accuracy standards.

- Ability to work both independently and collaboratively with multidisciplinary teams.

- Knowledge of purchased referred care and referrals policies and processes preferred.

QUALIFICATIONS:

- Bachelor’s degree in office management, Community Health Services, Healthcare Administration, or related field required.

- Minimum 3 years of experience in medical office operations, billing, referrals, or health administration required.

- Prior experience with referral coordination, authorization management, or scheduling preferred.

- Experience with HER platforms, payer authorization portals, and reporting systems strongly preferred.

- Experience in a large hospital, academic medical center, outpatient health care setting, or Indian Health Service (IHS)/ tribal health is preferred.

- A valid driver’s license is required.

Must clear a pre-employment drug screen in accordance with the Seneca Nation Drug, Alcohol and Controlled Substance Policy and the required Federal Fingerprint Background Investigation.

Disclaimer: The information in this position description has been designed to indicate the general nature and level of work performance by employees in this position. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position. Employees will be asked to perform other duties as needed.