RN Case Manager Home Care - | , | Group

Clinical Manager

Explore opportunities with Almost Family, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. #LHCJobs

As the Clinical Manager, you are responsible for ensuring high-quality, cost-effective patient care. You oversee the daily operations of the agency, managing key functions such as scheduling, staffing, intake, physician communication, billing, and compliance. Your leadership keeps everything running smoothly, ensuring both clinical excellence and operational efficiency.

Primary Responsibilities:

• Evaluate patient eligibility and reimbursement criteria for home care services; collaborate with Agency Director on referral acceptance and care planning
• Schedule and ensure timely documentation of initial assessments
• Coordinate with Case Coordinators to ensure appropriate staffing and coverage
• Monitor patient utilization for compliance with physician orders, agency policies, and funding guidelines; investigate and resolve unfilled shifts
• Assist with scheduling for Case Managers, nurses, and PRN staff; ensure timely and accurate documentation submission
• Approve and update plans of care (POC), including verbal orders, medications, and treatments
• Ensure timely completion of recertifications and verify plan of care content and compliance with policies
• Conduct routine and supervisory field visits as required by state regulations
• Support training and orientation of newly hired nurses, caregivers, and staff

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Registered Nurse (RN) license in the state of practice
• Solid understanding of home care regulations and reimbursement mechanisms
• Ability to manage schedules, documentation, and compliance processes

State Specific Requirements: (remove as applicable)

• WI: Minimum 1 year of supervisory or administrative experience in personal care or related program

Preferred Qualifications:

• Bachelor's degree in nursing, healthcare, healthcare technology, or education
• 1+ years of home care experience
• Supervisory or management experience
• Experience in staff training or orientation

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.