Clinical Case Manager, Care Management

Overview Ensures the quality, safe delivery, and cost-effective home care services. Coordinates home care services that reflect VNS Health's philosophy and ensures standards of care are maintained. Works under general direction. What We Provide Referral bonus opportunities Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability Employer-matched retirement saving funds Personal and financial wellness programs Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities What You Will Do Review all clinical documentation completed by Registered Nurse Field Supervisors (RNFS) for comprehensiveness, accuracy, proper formatting, legibility, and compliance with standards of care. Maintain collaborative relationships with personnel from other provider organizations to coordinate patient services, develop joint educational initiatives, and ensure compliance with contractual clinical management obligations. Develop, implement, and maintain clinical policies and procedures in collaboration with team members while ensuring adherence to accreditation and regulatory standards. Participate in the development and maintenance of clinical evaluation tools used for RNFS screening, orientation, and field performance assessments. Contribute to the planning and development of business strategies focused on expanding nursing service opportunities. Assist in developing marketing strategies and actively participate in marketing initiatives to support business growth. Provide on-call coverage based on departmental needs. Counsel and advise individuals inquiring about services regarding appropriate levels of care and referral pathways for members and caregivers. Serve as a clinical resource and subject matter expert for staff across the organization. Ensure the delivery of high-quality patient care within the assigned area by supporting schedulers and RNFS in completing timely field visits for supervision, assessment, training, support, and crisis management. Anticipate and prevent patient incidents by addressing potential care or service-related issues communicated by Clinical Case Managers (CCMs), supervisors, HHAs, RNFS, patients, and caregivers. Participate in the investigation of incidents and complaints within the assigned area and collaborate with leadership on disciplinary actions when necessary. Support department leadership in onboarding and educating new staff members. Conduct field supervision and performance oversight for RNFS during their initial three months in a new role and annually thereafter. Monitor email communications to identify changes in patients' clinical conditions that may require escalation or modifications to the aide plan of care. Evaluate the effectiveness and efficiency of care and services provided, initiating case management conferences with healthcare team members as appropriate. Ensure all services are delivered in accordance with accepted nursing practices, regulatory requirements, and accrediting body standards. Participate in Quality Assurance and Performance Improvement (QAPI) activities as assigned. Assist with special projects and perform additional duties as assigned. Qualifications Licenses and Certifications: License and current registration to practice as a Registered Professional Nurse, in New York State required CPR Certification required Education: Bachelor's Degree in Nursing from an approved program required Master's Degree in Nursing preferred Work Experience: Minimum two years clinical experience required Minimum of two years managerial experience in a LHCSA or CHHA preferred Proficiency in Microsoft Office applications required Excellent problem‑solving and organizational, interpersonal, verbal, and written communication skills required Pay Range USD $93,400.00 - USD $116,800.00 /Yr. #J-18808-Ljbffr