Manager, Post-Acute Engagement

Job Summary

WellBe Senior Medical was founded in 2019 to provide a more effective and personalized healthcare experience for patients living with chronic conditions. Our home-based medical visits nurture all aspects of a patient’s well-being so they can live better, feel healthier, and stay independent longer. With our mission at the forefront of everything we do, we aim to build our team with the most capable and compassionate individuals we can find. Named a Best Place to Work from Modern Healthcare, WellBe is a leading provider of in-home medical care and mental health services across the country!

Job Description

We are seeking a creative, passionate, experienced, proactive and compassionate Manager for Post-Acute Engagement within our Community Engagement Specialist team to design, implement, and manage a process for field-based staff to engage with seniors experiencing chronic health conditions during and immediately after hospital, emergency department or rehabilitation center admissions. This role will lead process implementation across WellBe’s national Community Engagement Specialist team. The primary goal is to ensure a smooth transition to WellBe home-based care services upon discharge, improving outcomes and reducing avoidable readmissions.

This individual will play a critical role in coordinating in-person engagement strategies, creating and facilitating related education and development of SOPs. The role is also responsible for efficacy monitoring and accelerated process and team improvement.

Key Responsibilities:

Program Development & Implementation

• Design and implement a scalable process for field staff to identify and meet with eligible seniors post-acute events.
• Develop workflows, protocols, and training materials for effective patient engagement and enrollment.
• Establish KPIs to monitor the success of field-based outreach and enrollment initiatives.
• Review detailed process and outcome measures and lead rapid cycle improvements to the Community Engagement Specialist team.
• Develop best practices for achieving hospital partnerships.
• Stay abreast of best practices nationally for field engagement, especially for post-acute events.

Collaboration & Relationship Management

• Partner with our Network Development team to build and maintain strong relationships with hospitals and skilled nursing facilities (SNFs/Rehabilitation centers) to facilitate access and coordination.
• Work closely with internal care teams to ensure continuity of care during the transition from facility to home.
• Work closely with our Marketing team to develop customized patient and facility-facing collateral on transitions of care value

Training & Oversight

• Train and mentor field-based staff on engagement strategies, communication best practices, and documentation standards.
• Monitor performance and provide ongoing feedback to ensure consistent and high-quality execution of enrollment efforts.

Compliance & Reporting

• Ensure all activities adhere to HIPAA and other relevant healthcare regulations.
• Track and report on enrollment metrics, patient satisfaction, and outcomes post-discharge.

Job Requirements

Required:

• Fanaticism for the WellBe mission and belief that every person deserves support after a hard health moment.
• Bachelor’s degree Public Health, or related field.
• Minimum 5 years of experience in care coordination, transitional care, or patient outreach with seniors or chronic care populations.
• Experience working in or with hospitals, SNFs, or community-based health programs.
• Strong understanding of healthcare systems and discharge planning processes.
• Familiarity with home-based care models and community health outreach strategies.

Key Competencies:

• Excellent interpersonal and communication skills.
• Ability to work independently and manage a mobile/field-based role.
• Compassionate and patient-centered mindset.
• Agile with new and multiple technology systems.
• Competency in Excel and ability to manage data.
• Strong organizational and documentation abilities.
• Ability to collaborate across interdisciplinary teams.

Working Conditions: