HERS Breast Cancer Foundation (“the Foundation”) is seeking a full-time Program Director to oversee its programs and services which provide breast cancer patients and survivors with assessment and fitting services, and products including breast prosthetics and pocketed bras, compression garments to alleviate breast cancer-related lymphedema, and wigs.
In continuous operation since 1998, the Foundation is an invaluable community resource with the mission of supporting all individuals healing from breast cancer by providing post-surgical products and services regardless of patients’ financial resources. Mission fulfillment is achieved through three assistance programs which ensure that low income, under-insured, and uninsured breast cancer patients may access products and services that help them heal physically and emotionally.
An accredited Durable Medical Equipment (DME) provider and a 501(c)3 nonprofit organization, the Foundation operates its primary location in Fremont and a satellite location in San Leandro. The Program Director is expected to work full-time and in person at the Fremont location but should be flexible regarding working at the San Leandro location.
Programs and services are sustained by insurance reimbursement for dispensed products as well as year-round fundraising and grant writing efforts. Additionally, the Foundation is generously supported by volunteers who provide day-to-day administrative and event-specific assistance.
As with all positions at the Foundation, bilingual/multi-lingual candidates are encouraged to apply.
The Program Director is responsible for the implementation of the Foundation’s patient programs and services in a manner that ensures the best possible patient outcomes while also ensuring programs are sustained. Duties include managing patient relations, product budgeting, sourcing, and ordering, inventory management, developing and maintaining vendor relations, and coordinating the authorization and scheduling processes as well as insurance billing.
The Program Director is also tasked with developing a budget for program staff and managing staff; this includes Breast Care Specialists (fitters), Breast Care Support Specialists, Medical Receptionists, and an Insurance Authorization Specialist, and Patient Scheduler. The number of staff ranges from eight to10 full-time and part-time individuals.
To ensure regulatory compliance, the Program Director sees that Breast Care Specialists obtain and keep their certification current, encourage ongoing education by taking advantage of training opportunities, and adhere to the requirements set forth by the Foundation’s accreditation body. Additionally, this role is tasked with ensuring that the Foundation’s patient health record and inventory/invoicing systems are operational, responsibly managing patient billing Accounts Receivable, and ensuring that patient products are dispensed and billed properly.
Key Responsibilities
1. Patient Program and Staff Management:
Hire, train, and supervise mastectomy fitter trainees and ensure that they obtain their certification (CFm) within 6 months of their hire date. This includes ensuring that staff members adhere to the highest standards of compassionate and professional patient care.
Supervise and/or provide direct fitting services, if needed, during peak hours or low staffing occurrences and complex cases. Manage patients requiring additional assistance, including handling patient escalations.
Hire, train, and supervise Insurance Specialist(s), Appointment Scheduler(s), and Medical Receptionist(s). ensure that they follow Foundation policies and procedures. This includes ensuring that staff members adhere to the highest standards of compassionate and professional patient care.
Establish and manage operational procedures for patient referral and eligibility processing, appointment scheduling and intake, product fitting assessment, and product selection (includes ready to wear and custom solutions), product dispensing and fulfillment, and fitting evaluation and documentation.
Establish and achieve annual Program revenue targets in line with the Foundation’s overall budget goals. Manage inventory budgets and product margins to ensure compliance with budget targets.
Collaborate with the Executive Director regarding patient Assistance Program applications; ensure that products are dispensed for approved patient applications in a timely manner, and the foundation funds are applied in compliance with all financial processes and procedures.
Oversee continuing education and ensure all team members stay up to date on product information, compliance, and/or industry changes/mandates.
Coordinate insurance contract rate changes and coverage updates with the Foundation’s staff and billing vendor.
2. Operations, Inventory, and Compliance
Manage vendor relationships with DME manufacturers and medical supply distributors to secure cost-effective pricing, bulk purchasing agreements, or new product donations.
Manage billing vendor relationship, and address insurance claim processing questions, escalations, and application of payment reimbursements,
Maintain rigorous inventory management protocols, utilizing software to manage product supplies in a diverse range of sizes and colors, and compression levels.
Ensure strict compliance with HIPAA regulations, patient privacy standards, and health facility cleanliness/sanitization protocols for fitting rooms.
Oversee clinical charting and documentation to ensure accurate tracking of patient histories and program metrics.
Conduct annual inventory at all locations by the end of June.
Coordinate with the Executive Director and/or other staff to manage private insurance contracts, Medicaid managed care organization, and Medicare to ensure proper billing. Manage prior authorizations and collaborate with the Foundation’s billing vendor regarding denied claims appeals.
Prepare program reporting and metrics, and participate in Foundation Board Meetings, scheduled bi-monthly.
3. Stakeholder Engagement & Strategic Partnerships
Cultivate relationships with clinical partners, including breast surgeons, oncologists, oncology nurses, and physical therapists specializing in lymphedema care.
Collaborate with the development team to supply qualitative patient stories, quantitative impact metrics, and demographic data for breast cancer foundation grants.
