Clinical Manager

Description: Responsible for assessing patient care needs and initial planning for patients referred to home health care services. Provides guidance and oversight to clinical field staff to ensure regulatory compliance, optimal quality of care and case management and timely, accurate documentation. JOB DUTIES /KNOWLEDGE (30%) _____ 1. Coordinates, screens and assesses home health care needs of patients referred to Agency _____ 2. Completes intake process within established time parameters and notifies referring party if patient will require alternative discharge plan _____ 3. Collaborates with physicians, nurses and discharge planners to identify patient care needs and to establish the appropriate level of care for patients referred to the Agency _____ 4. Ensures the completion of a comprehensive, individualized Plan of Treatment in accordance with MD orders, patient care needs, insurance guidelines and Agency protocol, including the identification of formal/informal supports in carrying out plan _____ 5. Ensures that the needed DME, medical supplies and ancillary services are ordered and documented _____ 6. Schedules and assigns visits for field staff _____ 7. Contacts managed care personnel when appropriate to obtain necessary authorizations _____ 8. Conducts case conferences with clinical personnel to ensure appropriate case management and coordination and timely discharge planning _____ 8. Delegates specific tasks to support staff providing clear, timely direction to ensure continuity of care _____ 9. Serves as a resource to all persons contacting the agency for information _____ 10. Reviews admission and recertification documentation and physician orders to ensure that care plan is appropriate and meets patients’ needs _____11. Treats all referral parties, patients, family members and staff courteously and in a non-discriminatory manner _____12. Demonstrates sound knowledge of reimbursement and billing practices for Medicare, Medicaid, managed care, charity care and other third party payors _____12. Demonstrates cultural sensitivity _____13. Maintains patient confidentiality at all times _____14. Demonstrates working knowledge of State and Federal regulations _____15. Participates in Quality and Performance Improvement activities and in the Orientation process for agency staff _____16. Performs other related duties as required _____17. Demonstrates a high degree of commitment to customer relations and quality service _____18. Utilizes community resources as appropriate to meet patient care needs _____ 19. Participates in the on-call supervisor rotation _____ 20. All other duties as assigned. QUALIFICATIONS License to practice as a registered nurse in the state, BSN preferred Minimum of three years nursing experience required Two years of home health nursing preferred Knowledge of OASIS and clinical documentation standards Effective verbal and written communication skills Excellent problem-solving skills Ability to organize multiple responsibilities and set priorities Excellent skills in customer relations #J-18808-Ljbffr