Humanaposted 12 days ago
$77,200 - $106,200/Yr
Full-time • Mid Level
Bluffton, SC
Insurance Carriers and Related Activities

About the position

The Clinical Manager, Home Health Nursing enables patients to stay in their homes by providing health and personal services; supporting patients and their families. The Clinical Manager, Home Health Nursing works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. This role is focused on both home health clinical quality assurance and home health clinical operations initiatives.

Responsibilities

  • Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed.
  • Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies.
  • Manages the assignment of caregivers.
  • Responsible for and oversees the delivery of care to all patients served by the location.
  • Receives case referrals and reviews available patient information related to the case.
  • Ensures patients meet admission criteria and makes the decision to admit patients to service.
  • Assigns appropriate clinicians to a case, as needed.
  • Instructs and guides clinicians to promote more effective performance and delivery of quality home care services.
  • Assists clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing patient Plan of Care (POC).
  • Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers.
  • Coordinates communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning.
  • Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals.
  • Participates in sales and marketing initiatives.
  • Supervises all clinical employees assigned to a specific location.
  • Handles necessary employee corrective action and discipline issues fairly and objectively.
  • Participates in the interviewing, hiring, training, and development of direct care clinicians.
  • Evaluates staff performance relative to job goals and requirements.
  • Assesses staff education needs and creates and conducts regular staff education as needed.
  • Analyzes situations, identifies problems, and evaluates alternative courses of action.
  • Responsible for review of the appropriate number of Case Managers and clinical staff documentation.
  • Responsible for the QA/PI activities.
  • Provides direct patient care on an infrequent basis and only in times of emergency.
  • Acts as Branch Director in his/her absence.
  • Interprets Company standards and policies to ensure compliance with external regulatory authorities.
  • Participates in performance improvement activities and maintains ongoing clinical knowledge.
  • Maintains relationships with referral/community sources and participates in professional organizations.

Requirements

  • Graduate of an accredited School of Nursing.
  • Current state license as a Registered Nurse.
  • Proof of current CPR.
  • Valid driver's license, auto insurance and reliable transportation.
  • Two years as a Registered Nurse with at least one-year of management experience in a home care, hospice or equivalent environment.
  • Home health experience is required.
  • Management and people leadership experience, required.

Nice-to-haves

  • OASIS experience, preferred.
  • OASIS certification (HCS-O, COQS, and/or COS-C), preferred.
  • Homecare Homebase (HCHB) experience, preferred.
  • CMS PDGM billing knowledge and/or experience, preferred.

Benefits

  • Medical, dental and vision benefits.
  • 401(k) retirement savings plan.
  • Paid time off, company and personal holidays, volunteer time off.
  • Paid parental and caregiver leave.
  • Short-term and long-term disability.
  • Life insurance.

Job Keywords

Hard Skills
  • Care Planning
  • Case Management
  • Clinical Supervision
  • Direct Patient Care
  • Home Health Nursing
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