Clinical Team Lead - RN

Clinical Team Lead

Lebanon

The Clinical Team Lead provides support to the operational and clinical division of the home health agency. In supporting and under the direction of Clinical Director/Clinical Manager, this position supports all patient care services and personnel including nursing, home health aide, medical social work, physical therapy, speech-language pathology and occupational therapy staff and contractors for the Medicare certified home health agency. This position assists with: making patient and personnel assignments; coordinating patient care; coordinating referrals; assuring that patient needs are continually assessed; and assuring the development, implementation, and updates of the individualized plan of care. Monitors and ensures medical records are maintained appropriately; participates in clinical record review and chart audits and maintenance of medical supplies. Tracks, monitors, submits and follows-up on all Review Choice Demonstration (RCD) and billing issues timely. Participates with the Directors and Administrator in the Quality Assessment and Performance Improvement process and assures that all clinical assignments are made according to licensure, state law, and Medicare/Medicaid standards for Home Health. The Clinical Team Lead reports to and receives consultation, direction and supervision from the Clinical Director/Clinical Manager.

Planning, Organizing & Implementation

1. Provides support, supervision and consultation to the clinical staff.
2. Clinically verifies patient care by performing the following functions:
3. Making patient and personnel assignments;
4. Coordinating patient care;
5. Assuring that patient needs are continually assessed; and
6. Assuring the development, implementation, and updates of the individualized plan of care.
7. Following up on clinical issues
8. Serves as a resource to all agency personnel regarding clinical and operational activities.
9. Assists with the provision of clinical care including: nursing, aide, medical social work and therapy services to patients in Home Health consistent with standards of practice, community need, agency policies and procedures, Medicare/Medicaid guidelines and State Home Health licensure laws.
10. Participates in, supports and incorporates Process Improvement principles into clinical service delivery.
11. Participates in, supports and incorporates program planning related to service delivery and evaluation of agency programs.
12. Monitors the provision of clinical care to patients and provides skilled nursing care on an as-needed basis.
13. Works with clinical staff to assist as needed with difficult care issues and to adjust patient plans of care.
14. Tracks patient cases that are high risk for hospitalization and coaches field clinicians on interventions and visit frequencies to prevent hospitalizations.
15. Advises, assists and collaborates with clinicians on an as-needed basis to assess patient situations, staff problems, and coordinates physician referrals.
16. Ensures that each patient receives quality care consistent with agency policies based on patient need and state/federal guidelines.
17. Monitors clinical documentation and assures the documentation is completed in the required timeframes. Specifically monitors for submission of the admission paperwork, medications being entered in the EMR, messages being sent to the coders when a document is ready for coding, care needs, orders and visit frequencies have been entered on the plans of care, post admission reviews of visit frequencies occur within the benchmarks or justifiable exceptions.
18. Participates in performance improvement activities including Outcomes Based Quality Indicators (OBQI).
19. Performs quarterly chart audits.
20. Attends and participates in clinical team meetings.
21. Utilizes clinical knowledge and skills in overseeing the provision of patient care to home health patients on a high quality, consistent basis in accordance with the mission of Otterbein Home Health.
22. Demonstrates basic keyboarding and computer skills and is able to use agency software.
23. May represent home health at the Otterbein independent living or assisted living meetings upon request.
24. Verifies proper maintenance of medical/clinical records.
25. Complies with and instructs staff in general orientation to agency policies and procedures.
26. Assists with the planning and evaluation of the Infection Control and Safety program.
27. In absence of the Clinical Director/Clinical Manager, assumes the role of the Clinical Director/Clinical Manager.

Human Resource Management

1. Reports and assists the Clinical Director/Clinical Manager regarding any clinical performance issues of clinical field staff or contract personnel.
2. Helps identify staff development needs and ensures that inservices are held and continuing education opportunities for staff are sought and encouraged.
3. Assists with the orientation of nursing and home health aide personnel.
4. Informs the Clinical Director/Clinical Manager of patient care, staffing issues and/or personnel issues on a timely basis.
5. Assists the Clinical Director/Clinical Manager that services are coordinated and care is available through Home Health Care RNs 24 hours a day, 7 days per week. May serve as the back-up or relief RN on call upon request.
6. Ensures that home health care nurses and aides receive supervision, via appropriate nursing staff.
7. Assists the Clinical Director/Clinical Manager by verifying the clinical competency of nursing and home health aide personnel.

Fiscal Responsibilities:

1. Understands the need for staff and contractor productivity and effective utilization.
2. Assures patient visits are scheduled to the appropriate field clinician and seeks direction from the Clinical Director/Clinical Manager when unsure of how to proceed.
3. Assigns patient visits with effective and efficient utilization of personnel in accordance with established productivity guidelines.
4. Monitors patient records for RCD or billing readiness
5. Assists with retrieving and submitting necessary patient documentation for UTN assignment.
6. Reviews patient documentation that establishes home health eligibility (Face to Face, plans of care, provider orders, etc.)
7. Monitors the online website of the fiscal intermediary (Palmetto) for affirmations of submitted RCD documents.
8. Once the affirmation is received, assures the UTN number is added to the patient record in the electronic medical record for billing.
9. Communicates with billing personnel when invoices are ready for billing on a daily basis.
10. Tracks, follows-up on and re-submits necessary documentation for any RCD non-affirmations timely.
11. Keeps the Clinical Director/Clinical Manager apprised of any issues with RCD or billing.

Leadership/Professionalism

1. Maintains current knowledge of home health principles and practices.
2. Maintains current knowledge of nursing practice acts, standards of practice, applicable laws, regulations, and practices.
3. Develops and maintains cooperative working relationships with other home care agencies, professionals and referral sources in order to encourage the exchange of information and services and to upgrade the level of professionalism and quality of home care services.
4. Attends external meetings as directed and presents information on Otterbein Home Health services to outside sources upon request.
5. Able to exercise independent judgment, critically analyze situations and make recommendations using appropriate problem-solving skills.
6. Able to manage competing demands for time and resources and independently prioritizes work responsibilities.
7. Able to function effectively as a member of a team.
8. Maintains confidentiality of patient and agency information according to HIPAA guidelines.
9. Maintains an appearance that projects a professional image.
10. Maintains satisfactory attendance.
11. Able to resolve conflict situations.
12. Identifies and progresses toward meeting personal and professional goals.
13. Demonstrates awareness of own behavior and its effect on others and the agency's productivity and effectiveness.
14. Performs other duties as assigned.

Human Relations

1. Must maintain a professional attitude and demeanor and be able to communicate effectively and relate courteously and cooperatively with patients, caregivers, colleagues, supervisors, co-workers and all others.
2. Must be able to demonstrate optimism, enthusiasm and willingness to work constructively with other members of the health care team and reflect concern for the well-being of patients and employees.
3. Professionally shows genuine concern for those with whom he or she has a working relationship.
4. Demonstrates responsibility for enhancing professional growth.
5. Verbal and written communications are understandable with attention given to feelings, opinions, and attitudes of others. Personnel are kept informed of changes that affect them through meetings, correspondence, email and voicemail which are utilized appropriately.
6. Develops and maintains good working relationships with other staff, community health