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

The Clinical Manager, Home Health Nursing enables patients to stay in their homes by providing health and personal services; supporting patients and their families. The Clinical Manager, Home Health Nursing works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.

               

The RN Clinical Manager will be:
• Responsible for Referral Intake and Management to ensure that clients receive assessment visits and that these visits are scheduled and performed timely.
• Lead weekly Case Conference and address recert / discharge decisions based on Case Conference findings. Review and approve Case Conference coordination notes and attach to Episode Detail Report. Enter Case Conference coordination notes within 48 hours of the Case Conference meeting. Contact physicians to obtain orders for continued service provision or add-on services.
• Review orders as they appear on the action screen. Approve or decline as appropriate. Follow up with Licensed Professional as necessary when editing an order.
• Enter and approve all orders for tracking purposes and route to Medical Records to be sent for physician signature. Ensure any corrections are made by the Licensed Professional who wrote the order prior to approving the order. Update the client’s medication profile and schedule as applicable via the order. Ensure all orders that address frequency have appropriate calendar modification completed.
• Ensure that there are existing orders for requested medical supplies.
• Follow up on orders from the Order Tracking Report when the MRS is unable to retrieve the unsigned order.
• Enter detailed Non-Admit information into HCHB in coordination notes if no visit was made. Ensure the Branch Director approved the non-admission.
• Review and process vital sign alert reports. Document action, any follow-up and physician notification.
• Review and process all wound score deviations documenting any action and/or follow – up.
• If clinical, may be required to perform patient visits and / or participate in an on-call rotation
• Review and follow up on entitlement verification issues. Document action in coordination notes.
• Verify benefits and obtain authorization for services on all non-Medicare patients.
• Review On-Call coordination notes reports regularly. Follow up on identified deficiencies related to billing claims audit within 24 hours follow receipt of the Billing Claims Held Reports.
• Run the Notification of Missed Visits reports and submit weekly to physicians.
• Act as a backup for the Patient Services Coordinator in rescheduling missed and declined visits and processing reassigned and reschedule requests to ensure timely completion of these tasks.
• If the PSC is not an LVN/LPN, receives lab reports and assesses for normality. Forward lab reports to the PSC for faxing to the physician.
• Function as staff nurse PRN.

Use your skills to make an impact
 

• Must be a graduate of an approved school of professional nursing and hold an active RN license.

• Must have a minimum of two years nursing experience and one year experience in home health.
• Supervisory experience is preferred.

• Must have a good understanding of the Federal, State, and Local laws / regulatory guidelines governing the operation of a home health agency.
• Must be organized and able to effectively communicate both orally and in writing.
• Must be capable of multi-tasking while maintaining a professional and friendly demeanor.
• Must be adept at communicating with a broad range of individuals and possess excellent customer service skills.
• Must be competent with computers.

Scheduled Weekly Hours

10

About us
 

About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive in-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 nation’s 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 30,000 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.