RN CLINICAL MANAGER HOME HEALTH - Vertus HealthCare

The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel.

• Develops, plans, implements, analyzes, and organizes clinical operations.
• Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies.
• Responsible for and oversees the delivery of care to all patients served by the location.
• Receives case referrals. Reviews available patient information related to the case, including disciplines required, to determine home health or hospice needs.
• Accountable to ensure patients meet admission criteria and make the decision to admit patients to service. Assigns appropriate clinicians to a case as needed.
• Assist clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing patient Plan of Care (POC).
• Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers.
• Ensures final audits/billing are completed timely and in compliance with Medicare regulations.
• Coordinates communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning.
• Analyzes situations, identifies problems, identifies, and evaluates alternative courses of action through the utilization of Performance Improvement principles.
• Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review and outcomes of care analysis to determine efficiency the efficacy of case management system as well as any other systems and process.
• Provides direct patient care on an infrequent basis and only in times of emergency.
• Participates in performance improvement activities, maintains ongoing clinical knowledge through internal and external training programs.

Required Experience/Skills

• 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.
• Medicare Home Health Experience REQUIRED.
• Two years as a Registered Nurse with at least one year of management experience in a home care, hospice, or equivalent environment.