Registered Nurse Clinical Manager

RN Clinical Manager The RN Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. This role focuses on home health clinical quality assurance and home health clinical operations initiatives. Responsibilities Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. Conducts and delegates the assessment and reassessment of patients, including updating care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures and policies. Manages the assignment of caregivers. Responsible for and oversees the delivery of care to all patients served by the location. Receives case referrals and reviews available patient information related to the case to determine home health or hospice needs. Ensures patients meet admission criteria and decides on patient admission 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, setting priorities, and developing patient Plan of Care (POC). Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers, and ensures final audits and 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 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, and performs all 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 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 review of clinical documentation and feedback from Utilization Review staff; creates and conducts regular staff education as needed. Analyzes situations, identifies problems, and evaluates alternative courses of action through the utilization of Performance Improvement principles. Reviews the appropriate number of Case Managers and clinical staff documentation—including starts‑of‑care, resumption‑of‑cared, and re‑certifications—for appropriateness of care, delivery, and documentation requirements. Conducts QA/PI activities and collaborates with Utilization Review staff on data tracking for performance review and outcomes of care analysis to determine efficiency and efficacy of the case management system and other processes. Competes in patient care assignments and staff management activities. 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 and maintains ongoing clinical knowledge through internal and external training programs. Provides interpretation of knowledge and direction to staff. Maintains relationships with referral and community sources, participates in professional organizations, and conducts care‑related programs. Performs other related duties as assigned or requested. 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 health, hospice, or equivalent environment. Certified Home Health Agency experience is required (NY state requirement) or four years of CHHA experience and six credit hours toward a BSN. Management and people leadership experience (preferred). OASIS experience (required); OASIS certification (HCS-O, COQS, or COS-C) preferred. Homecare Homebase (HCHB) experience (preferred). CMS PDGM billing knowledge and/or experience (preferred). Work Schedule Full‑time, 40 hours per week. On‑site at Westbury, NY branch location. Normal hours of operation: Monday–Friday, 8 a.m.–5 p.m. (ET). On‑call expectation: Rotating on‑call shift. Branch size: 170 census (4‑STAR rating). Compensation and Benefits Pay range: $92,600 – $127,400 per year. Annual incentive bonus available with quarterly and annual payouts. Competitive benefits including medical, dental and vision coverage; 401(k) retirement savings plan; paid time off, holidays, volunteer time off, paid parental and caregiver leave; short‑term and long‑term disability; life insurance; and additional opportunities. 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 CenterWell Home Health