Clinical Manager, Home Health

Clinical Manager

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

Responsibilities include :

• Developing, planning, implementing, analyzing, and organizing clinical operations for a specific location managed.
• Conducting / delegating 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.
• Managing the assignment of caregivers.
• Responsible for and overseeing the delivery of care to all patients served by the location. Receiving case referrals. Reviewing 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. Assigning appropriate clinicians to a case, as needed.
• Instructing and guiding 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.
• Assisting clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing patient Plan of Care (POC).
• Monitoring cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers. Ensuring final audits / billing are completed timely and in compliance with Medicare regulations.
• Coordinating communication between team members / attending physicians / caregivers to ensure the appropriateness of care and outcome planning.
• Working in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals.
• Participating in sales and marketing initiatives.
• Supervising all clinical employees assigned to a specific location. Responsible for the overall direction, coordination, and evaluation of the location. Carrying out supervisory responsibilities in accordance with Company policies and procedures.
• Handling necessary employee corrective action and discipline issues fairly and objectively, in consultation with the Human Resources Department and the Executive Director / Director of Operations.
• Participating in the interviewing, hiring, training, and development of direct care clinicians. Evaluating their performance relative to job goals and requirements. Coaching staff and recommending in-service education programs, when needed. Ensuring adherence to internal policies and standards.
• Assessing staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creating and conducting regular staff education as needed.
• Analyzing situations, identifying problems, identifying and evaluating alternative courses of action through the utilization of Performance Improvement principles.
• Responsible for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, for appropriateness of care, delivery, and documentation requirements.
• Responsible for the QA / PI activities. Working 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. Competently performing patient care assignments and staff management activities.
• Providing direct patient care on an infrequent basis and only in times of emergency.
• Acting as Branch Director in his / her absence.
• Interpreting Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensuring that caregiver clinical documentation meets internal standards.
• Participating in performance improvement activities, maintaining ongoing clinical knowledge through internal and external training programs. Providing interpretation of knowledge and direction to staff.
• Maintaining relationships with referral / community sources. Participating in professional organizations and conducting care-related programs.
• Performing other related duties as assigned or requested.

Required Experience / Skills :

Scheduled Weekly Hours : 40

Pay Range : $93,900 - $129,300 per year

Description of Benefits : Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family.

About Us : CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization.

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.