Clinical Manager

The Clinical Manager ensures the overall coordination of home health services provided to all clients is delivered in a safe and effective manner. The role is responsible for facilitating the relationship between referral sources, patients, caregivers, and employees. Depending on branch census you may be responsible for other duties as assigned.

Essential Functions: ( Those functions that the individual who holds the position must be able to perform unaided or with the assistance of reasonable accommodation).

Clinical:

• 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. Date Issued: Date Revised: 2-28-20
• 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 Administrative:
• 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.

Knowledge/Skills/Abilities/Expectations:

• 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.

Qualifications:
Education:

• Must be a graduate of an approved school of professional nursing and hold an active RN license. Experience:
• Essential: Must have a minimum of two years nursing experience and one year experience in home health.
• Desired: Supervisory experience is preferred.

Requirements:

• Must possess a valid state driver’s license and automobile liability insurance
• Must be able to drive an automobile in all types of weather conditions
• Must have an RN license in the State of employment

Job Type: Full-time

Benefits:

• 401(k)
• Employee assistance program
• Health insurance

Schedule:

• Monday to Friday

Ability to commute/relocate:

• Stockton, CA: Reliably commute or planning to relocate before starting work (Preferred)

Education:

• Master's (Preferred)

Work Location:

• One location

Work Remotely:

• No