Registered Nurse Clinical Manager

RN Clinical Manager – On-site, Mayfield, KY Responsibilities Manage all direct care patient services provided by clinical personnel. Focused on home health clinical quality assurance and clinical operations projects. Develop, plan, implement, analyze, and organize clinical operations for the location. Conduct and delegate assessment and reassessment of patients, updating care plans and interpreting patient needs following company, physician, or facility procedures. Assign and manage the assignment of caregivers. Oversee delivery of care to all patients at the location, receiving case referrals and reviewing patient information to determine home‑health or hospice needs. Ensure patients meet admission criteria and make admission decisions; assign appropriate clinicians to cases. Guide clinicians to promote performance and delivery of quality home‑care services; be available during operating hours to assist clinicians. Assist clinicians in establishing immediate and long‑term therapeutic goals, setting priorities, and developing patient Plan of Care (POC). Monitor cases to ensure documentation compliance with regulatory agencies and third‑party payer requirements; ensure final audits/billing comply with Medicare regulations. Collaborate with the Branch Director and Company Finance Department to set location revenue and budget goals. Participate in sales and marketing projects. Oversee all clinical employees at the location, performing supervisory responsibilities and evaluating performance per company procedures. Handle employee corrective action and discipline issues fairly with HR and Executive leadership. Participate in interviewing, hiring, and training of direct‑care clinicians; evaluate performance relative to job goals and recommend in‑service education. Assess staff education needs based on clinical documentation reviews, feedback, and utilization review recommendations; conduct regular staff education. Lead QA/PI activities; work with Utilization Review staff to track data for performance reviews and outcomes analysis. Provide direct patient care only infrequently and in emergencies. Act as Branch Director in their absence. Participate in performance improvement activities and maintain ongoing clinical knowledge through internal and external training programs. Maintain relationships with referral and community sources; participate in professional organizations and related programs. Qualifications 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 of RN experience with at least one year of management experience in home‑care, hospice or equivalent environment. Home‑health experience required. Management and people‑leadership experience required. OASIS experience required; OASIS certification (HCS‑O, COQS, and/or COS‑C) preferred. Homecare Homebase (HCHB) experience preferred. CMS PDGM billing knowledge and/or experience preferred. Additional Details Work Schedule: Full‑time, 40 hours per week. Branch Hours: M‑F 8 a.m. – 5 p.m. (CT). On‑Call: As needed. Branch Size: 70 census (4.5‑star rating). Annual Bonus: Eligible for both quarterly and annual incentive payouts. Compensation: $77,200 – $106,200 per year (based on location and individual qualifications). Benefits Humana, Inc. offers competitive benefits including medical, dental and vision coverage, 401(k) retirement savings plan, paid time off, disability and life insurance, and additional wellness programs. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. Humana takes affirmative action in compliance with Section 503 of the Rehabilitation Act and VEVRAA to employ and advance in employment individuals with disability or protected veteran status, and bases all employment decisions only on valid job requirements. This policy applies to all employment actions, including but not limited to recruitment, hiring, promotion, transfer, layoff, recall, termination, pay, and training. #J-18808-Ljbffr CenterWell Home Health