Registered Nurse Clinical Manager

Job Overview Become a part of our caring community and help us put health first. Work Schedule: Full‑time / 40 hours per week. Position Type: On‑site. Branch Location: Westbury, NY. This is NOT a remote or work‑from‑home position. This position requires you to sit on‑site at our Westbury, NY branch location. RN Clinical Manager Coordinates and oversees all direct care patient services provided by clinical personnel. This role focuses on both home health clinical quality assurance and home health clinical operations initiatives. Key Responsibilities Develops, plans, implements, analyzes, and organizes clinical operations for a specific location. Conducts or delegates assessment and reassessment of patients, including updating 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, reviews available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission criteria and make 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, and is available at all times during operating hours to assist clinicians as appropriate. 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. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. Coordinates communication between team members, attending physicians, and caregivers to ensure the appropriateness of care and outcome planning. Works in conjunction with the Branch Director and Company Finance Department to establish the location’s revenue and budget goals. Participates in sales and marketing initiatives. Supervises all clinical employees assigned to a specific location. Responsible for the overall direction, coordination, and evaluation of the location. Carries out supervisory responsibilities in accordance with company policies and procedures. Handles necessary employee corrective action and discipline issues fairly and objectively, in consultation with the Human Resources Department and the Executive Director/Director of Operations. Participates in the interviewing, hiring, training, and development of direct care clinicians. Evaluates their performance relative to job goals and requirements. Coaches staff and recommends in‑service education programs, when needed. Assesses staff education needs based on the review of clinical documentation and feedback by Utilization Review staff. Creates and conducts regular staff education as needed. Analyzes situations, identifies problems, evaluates alternative courses of action through the utilization of Performance Improvement principles. Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review and outcomes of care analysis to determine efficiency, efficacy of case management system and other systems and processes. 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 and ensures caregiver clinical documentation meets internal standards. Participates in performance improvement activities, maintains ongoing clinical knowledge through internal and external training programs. Provides interpretation of knowledge and direction to staff. Maintains relationships with referral/community sources. Participates in professional organizations and conducts care‑related programs. Performs other related duties as assigned or requested. Required Experience / Skills 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 health, hospice or equivalent environment. Certified Home Health Agency experience is required (NY state requirement) or four years’ CHHA experience and six credit hours toward BSN. Management and people leadership experience, preferred. 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 Information Normal Hours of Operation: M‑F / 8a‑5p (ET) On‑Call Expectation: Rotating on‑call shift. Branch Size: 170 Census (4‑STAR rating) Annual Bonus: Eligible for the annual incentive bonus which has pay‑outs both quarterly and annually. Scheduled Weekly Hours: 40 Pay Range $92,600 – $127,400 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole‑person well‑being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short‑term and long‑term disability, life insurance and many other opportunities. Company Overview CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech‑language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior‑focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole‑person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry‑leading benefits and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well‑being, all from day one. 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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. #J-18808-Ljbffr