RN Clinical Manager - Lexington
$48.82k - $73.22kUnitedHealthcare At Home
Clinical Manager
Explore opportunities with Commonwealth Personal Care Services, 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.
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
- Driver's License and access to a reliable transportation
State Specific Requirements:
- KY: Minimum 2 years of RN experience in aging or disabilities
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
- Ability to manage schedules, documentation, and compliance processes
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 $48,816 to $73,224 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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