RN Clinical Manager

Become a part of our caring community and help us put health first

Work Schedule : Full-time / 40 Hours

Position Type : On-site

Branch Location : Grand Rapids MI

This is not a remote or work-from-home position. This position requires you to sit on-site at our Grand Rapids MI branch location.

The RN Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. This role is a focused on both home health clinical quality assurance and home health clinical operations initiatives.

• Develops plans implements analyzes and organizes clinical operations for a specific location managed.
• 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.
• Manages the assignment of caregivers.
• 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.
• Instructs and guides 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.
• Assists 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.
• Works in conjunction with the Branch Director and Company Finance Department to establish locations revenue and budget goals.
• Participates in sales and marketing initiatives.
• Supervises all clinical employees assigned to a specific location. Responsible for the overall direction coordination and evaluation of the location. Carries out supervisory responsibilities in accordance with Company policies and procedures.
• Handles necessary employee corrective action and discipline issues fairly and objectively in consultation with the Human Resources Department and the Executive Director / Director of Operations.
• Participates in the interviewing hiring training and development of direct care clinicians. Evaluates their performance relative to job goals and requirements. Coaches staff and recommends in-service education programs when needed. Ensures adherence to internal policies and standards.
• Assesses 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 creates and conducts regular staff education as needed.
• Analyzes situations identifies problems identifies and evaluates 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. 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. Competently performs patient care assignments and staff management activities.
• Provides direct patient care on an infrequent basis and only in times of emergency.
• Acts as Branch Director in his / her absence.
• Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical documentation meets internal standards.
• Participates in performance improvement activities maintains ongoing clinical knowledge through internal and external training programs. Provides interpretation of knowledge and direction to staff.
• Maintains relationships with referral / community sources. Participates in professional organizations and conducts care-related programs.
• Performs other related duties as assigned or requested.

Use your skills to make an impact

Required Experience / Skills :

Additional Information

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills knowledge experience education certifications etc.

$77200 - $106200 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

Description of Benefits

Humana Inc. and its affiliated subsidiaries (collectively Humana) offers 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 while also knowing your life extends outside of work. Among our benefits Humana provides medical dental and vision benefits 401(k) retirement savings plan time off (including paid time off company and personal holidays volunteer time off paid parental and caregiver leave) short-term and long-term disability life insurance and many other opportunities.

About Us

About CenterWell Home Health : CenterWell Home Health specializes in personalized comprehensive home care for patients managing a chronic condition or recovering from injury illness surgery or hospitalization. Our care teams include nurses physical therapists occupational therapists speech-language pathologists home health aides and medical social workers all working together to help patients rehabilitate recover and regain their independence so they can live healthier and happier lives.

About CenterWell a Humana company : CenterWell creates experiences that put patients at the center. As the nations largest provider of senior-focused primary care one of the largest providers of home health services and fourth largest pharmacy benefit manager CenterWell is focused on whole-person health by addressing the physical emotional and social wellness of our patients. As part of Humana Inc. (NYSE : HUM) CenterWell offers stability industry-leading benefits and opportunities to grow yourself and your career. We proudly employ more than 30000 clinicians who are committed to putting health first for our teammates patients communities and company. By providing flexible scheduling options clinical certifications leadership development programs and career coaching we allow employees to invest in their personal and professional well-being all from day one.

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. It is also the policy of Humana to take affirmative action in compliance with Section 503 of the Rehabilitation Act and VEVRAA to employ and to advance in employment individuals with disability or protected veteran status and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions including but not limited to recruitment hiring upgrading promotion transfer demotion layoff recall termination rates of pay or other forms of compensation and selection for training including apprenticeship at all levels of employment.

Required Experience :

Manager

Key Skills

CSS,Cloud Computing,Health Education,Actuary,Building Electrician

Employment Type : Full-Time

Experience : years

Vacancy : 1

Yearly Salary Salary : 77200 - 106200