Remote Medical Billing Rcm Jobs in Valley Center, CA

Lead Care Manager

The Lead Care Manager is a licensed nurse responsible for managing a direct patient caseload while overseeing the clinical performance, compliance, and output of an assigned team of Care Managers. In this position, you will maintain an active remote patient monitoring and/or chronic care management patient panel, direct the daily performance and documentation standards of your assigned team, and serve as the primary clinical point of contact for each assigned practice.

As a Lead Care Manager at Welby Health, you will hold accountability for the combined clinical output of each Care Manager and Medical Assistant pairing, identifying and escalating collaboration gaps that limit throughput or outcomes. Furthermore, you will translate Welby Health's clinical strategy into team-level execution and client-level results, representing Welby Health with clinical authority in client performance reviews, care coordination discussions, and escalation calls.

Key Responsibilities

• Manage a defined remote patient monitoring and/or chronic care management patient panel, meeting or exceeding individual production standards for clinical engagement hours, remote patient monitoring compliance, and unbilled time
• Complete accurate, timely documentation for every patient interaction in accordance with Welby Health protocols and applicable billing requirements
• Conduct proactive outreach, device data review, care plan updates, and care coordination consistent with the standards expected of the your assigned team
• Model the clinical engagement, documentation, and conduct standards the team is held to, and incorporate direct patient care insight into coaching, client discussions, and protocol review
• Direct the performance of your assigned team, ensuring daily productivity, documentation accuracy, and program compliance are consistently achieved
• Monitor individual and team-level key performance indicators, including clinical engagement hours, unbilled time rates, and remote patient monitoring compliance, and intervene early when trends indicate risk
• Identify breakdowns in Care Manager and Medical Assistant collaboration and escalate to leadership when structural support issues require resolution
• Conduct regular coaching sessions with Care Managers, grounded in performance data and connected to program outcomes
• Manage caseload distribution across your assigned team and escalate capacity constraints or clinical risk patterns to the leadership
• Direct the onboarding of new Care Manager, establishing clinical and documentation standards from the outset
• Provide ongoing training and coaching to resolve individual performance gaps as they arise
• Assume responsibility for patient care coverage during staffing shortages and escalate anticipated coverage needs to leadership in advance
• Track team productivity, patient enrollment, and patient churn to maintain real-time visibility into team and program health
• Partner with leadership to escalate patient care bottlenecks or emerging risks to program metrics before client outcomes are affected
• Maintain visibility into engagement and outcome trends across the personal caseload and team portfolio, identifying gaps in chronic disease management, remote patient monitoring adherence, and chronic care management touch frequency
• Translate direction from leadership into team-level priorities and communicate expectations clearly
• Contribute frontline clinical feedback to strategy review sessions that inform protocol updates, workflow adjustments, and staffing decisions
• Ensure your assigned team adheres to all regulatory requirements, payer guidelines, and Welby Health clinical protocols governing remote patient monitoring, chromic care management, principal care management, advanced primary care management, and behavioral health integration program delivery
• Coordinate regular chart audits for your assigned team, closing feedback loops and preventing repeat deficiencies
• Maintain working knowledge of billing compliance requirements and hold your assigned team accountable to documentation standards that protect program integrity
• Ensure all team members remain current on policy and workflow updates, and flag instances of non-compliance to leadership with a documented action plan
• Serve as the first point of escalation for clinical quality concerns raised by your team prior to senior leadership involvement
• Establish and maintain trusted, professional relationships with clinic administrators, medical directors, and care coordination staff
• Lead client-facing engagements, including performance reviews, care coordination discussions, and escalation calls, representing Welby Health with clinical authority
• Translate client feedback into operational direction for your assigned team, ensuring alignment with each clinic's preferences and workflows
• Identify and escalate client relationship risks, unmet program expectations, or patient safety concerns to leadership appropriate context and urgency
• Develop and maintain a client success plan for each assigned practice, defining program goals, performance targets, escalation protocols, and quarterly improvement priorities
• Translate client-specific objectives into team-level execution plans with clear ownership and timelines
• Deliver structured performance reporting to internal and external stakeholders on a regular basis
• Identify gaps between performance and client expectations and develop corrective action plans in advance of escalation
• Partner with leadership to support expansions, renewals, and new practice onboarding

Required Qualifications

• Bachelor's degree in nursing or a closely related healthcare field
• Active and valid registered nurse (RN) license in good standing
• Minimum of three (3) to five (5) years of clinical experience, with demonstrated background in care management, chronic disease management, or a population health program
• Prior experience in a lead or supervisory clinical role with direct reports, including accountability for team performance while carrying an individual caseload
• Working knowledge of remote patient monitoring, chronic care management, principal care management, or related chronic care program structures and documentation requirements
• Demonstrated ability to drive accountability across cross-functional teams without direct authority over all contributors
• Demonstrated ability to build and maintain professional client or provider relationships
• Ability to manage personal production standards alongside team and client responsibilities concurrently
• Exceptional written and verbal communication skills, with the ability to represent Welby Health credibly in client-facing settings
• Strong data fluency, with the ability to interpret dashboards, identify trends, and present findings to varied audiences

Preferred Qualifications

• Familiarity with remote physiological monitoring, electronic medical record (EMR) or electronic health record (EHR) systems, and patient engagement tools
• Experience working with Federally Qualified Health Centers or value-based care organizations

About Us

Welby Health is a San Diego-based healthcare organization committed to transforming the way complex conditions are managed. Our mission is to advance patient outcomes by integrating efficient care coordination, data-driven insights, and enhanced communication across the care continuum. Through a technology-enabled, clinically grounded service model, we partner with physicians and health systems to deliver scalable solutions that improve quality of care, increase practice efficiency, and empower patients to live healthier lives.

Equal Employer Opportunity

Welby Health, Inc. is an equal opportunity employer committed to diversity and inclusion. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital or veteran status, pregnancy, or disability. We provide reasonable accommodations for applicants and employees in alignment with their needs related to disability, mental health, or religious practices.