Registered Nurse Clinical Manager

RN Clinical Manager Become a part of our caring community. The RN Clinical Manager manages all direct care patient services provided by clinical personnel at our Mayfield, KY branch location. You will focus on both home health clinical quality assurance and home health clinical operations projects, reporting to the Branch Director. Responsibilities Develop, plan, implement, analyze, and organize clinical operations for a specific location managed. Conduct and delegate assessment and reassessment of patients, including updating care plans and interpreting patient needs while following company, physician, or health facility procedures. Manage the assignment of caregivers and oversee the delivery of care to all patients served by the location. Receive case referrals and review patient information to determine home health or hospice needs; ensure admission criteria are met and make admission decisions. Assign appropriate clinicians to a case and instruct them to promote performance and delivery of quality home care services. Assist clinicians in establishing immediate and long‑term therapeutic goals, setting priorities, and developing patient Plans of Care (POC). Monitor cases to ensure documentation complies with regulatory agencies and third‑party payer requirements; ensure final audits/billing are completed and in compliance with Medicare regulations. Work with the Branch Director and Company Finance Department to establish location revenue and budget goals. Participate in sales and marketing projects. Oversee all clinical employees assigned to a specific location and perform supervisory responsibilities following company procedures. Handle necessary employee corrective action and discipline issues fairly and objectively, in conjunction with Human Resources and the Executive Director/Director of Operations. Participate in interviewing, hiring, and training of direct care clinicians; evaluate performance relative to job goals and requirements. Coach staff and recommend in‑service education programs when needed; ensure adherence to internal policies. Assess staff education needs based on clinical documentation reviews and utilization review feedback; conduct regular staff education sessions upon assessment completion. Responsible for QA/PI activities; work with Utilization Review staff on data tracking for performance review and outcome analysis to determine efficiency and efficacy of programs and processes. Perform patient care assignments and staff management activities, including providing direct patient care on an infrequent basis during emergencies and acting as Branch Director in their absence. Participate in performance improvement activities and maintain ongoing clinical knowledge through internal and external training programs. Provide interpretation of knowledge and direction to staff; maintain relationships with referral and community sources; participate in professional organizations and conduct care‑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 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. 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. Compensation and Bonus Pay range: $77,200 – $106,200 per year. This range may vary based on geographic location and demonstrated job‑related skills, knowledge, experience, and education. The job is eligible for a bonus incentive plan based on company and/or individual performance. Benefits Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole‑person well‑being, including medical, dental, and vision benefits; a 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. Work Schedule Full‑time, 40 hours per week. Normal hours of operation: Monday – Friday, 8:00 a.m. – 5:00 p.m. (CT). On‑site at the Mayfield, KY branch location. Not remote or work‑from‑home. On‑call as needed. Equal Opportunity Employer Statement 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