Hospice Clinical Manager
Wellcare Home Health Inc
The Hospice Clinical Manager is responsible for the oversight of the Hospice clinical interdisciplinary team, including the planning, development, implementation, and daily management of clinical activities for Hospice. The Clinical Manager is responsible for ensuring that patient care is coordinated and managed appropriately and in compliance with all government regulations and quality standards. The Clinical Manager is responsible for establishing and maintaining requests and concerns and managing the insurance verification and authorization processes as appropriate. The Clinical Manager supervises and provides support, mentoring, and education to all clinical staff to ensure consistent, quality patient care and compliance with all government regulations.
PRIMARY JOB DUTIES
- Maintains comprehensive working knowledge of Well Care Hospice, Inc. contractual relationships and ensures that patients are admitted according to contract provisions.
- Establishes and maintains positive working relationships with current hospice partner agencies and organizations.
- Maintains comprehensive working knowledge of community resources and assists hospice team in assisting patients and families to access community resources, should services not be provided by Well Care Hospice, Inc.
- Supervise completion of clinical documentation according to agency, state, federal, and accreditation standards.
- Ensures patients receive quality care by reviewing documentation, consulting with staff, reviewing care plans, conducting/participating in interdisciplinary group conferences, and reviewing patient satisfaction reports.
- Ensures hospice home care services are provided in compliance with state, federal, and local regulatory requirements and established policies and procedures, quality/cost/clinical outcomes, and established performance standards.
- Conducts record reviews routinely and communicates findings and recommendations to Hospice Director and hospice personnel, reviewing patient's medical diagnosis, prognosis, medications, procedures, and clinical course.
- Work closely with the Medical Records Specialist to ensure that clinical records are maintained in compliance with agency, state, federal, and regulatory agency guidelines.
- Complies with accepted professional standards and principles.
- Participates actively in quality assessment performance improvement program.
- Performs other duties and activities as delegated by the Director.
- Assists in the provision of on-call services after hours, weekends, and holidays as scheduled and as needed.
- Managing personal work schedule and time off to promote smooth agency operations.
- Demonstrating flexibility with changing workload/assignments.
- Does not exceed accrued PTO or qualified leave of absence(s).
- Directs the implementation of improved work methods and procedures to ensure patients are admitted in accordance with government regulations and with policy.
- Provides leadership in strategic planning including identifying opportunities for additional or improved services to meet unmet customer needs.
- Oversees the daily functions of the hospice care team and serves as a resource to the interdisciplinary team members.
- Ensure customer service expectations of patients, families, physicians, long-term care facilities, and colleagues are exceeded.
- Assist with ensuring the hospice's readiness and compliance with state, federal, and regulatory agency standards.
- Directly supervises RN Case Managers, Social Workers, Chaplains, Hospice Aides, and LPNs, and conducts supervisory visits in the field with clinical staff as needed and at least annually.
- Promotes growth and development of clinical personnel; participates in competency assessment; creates developmental/improvement plans; identifies educational needs and recommends educational opportunities that would enhance patient care.
- Assesses health needs of community and assists in the development of plan(s)/ program(s) to meet needs. Participates in public relation and community activities that promote the organization's role as an effective member of the hospice and health care delivery system.
- Promotes customer service orientation to all hospice personnel.
- Receives and reviews patient referral information to determine hospice care needs. Collaborates with the Hospice Medical Director regarding any questions about an individual's eligibility for services as needed.
- Assists clinicians in establishing immediate and long-term patient goals, in setting priorities, and in developing plan of care.
- Attends IDG meetings and individual patient case conferences as necessary with hospice personnel to facilitate coordination of care and discussion of interdisciplinary group involvement.
- Work closely with Hospice Director to maintain and monitor the overall hospice expenses and keep the hospice within budget.
- Participates in recruitment and retention efforts to ensure optimal staffing.
- Assists Hospice Director and other supervisory hospice personnel in the planning, implementation and evaluation of in-service and continuing education programs. Assists in the formulating, revising, implementing, and evaluating organization policies, procedures, goals and objectives, both short and long range.
- Participates in long range strategic planning for department and agency, including program development and expansion.
- Maintain Well Care Health Guiding Principles by respecting and maintaining privacy and confidentiality of agency customers, and employees, by practicing financial responsibility in the best interest of the agency, by practicing safety measures, by communicating with courtesy and compassion to agency customers and employees, and by conducting self in a professional manner.
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