Patient Care Manager/Clinical Manager
2 days ago
We are seeking a highly skilled and experienced Patient Care Manager/Clinical Manager to join our team at Saint Mary's Home Care Services. As a Patient Care Manager, you will be responsible for the overall supervision and coordination of clinical services, ensuring the continuity of high-quality care to home health patients assigned to the team's area.
Key Responsibilities:- Coordinates and supervises an interdisciplinary team of staff to assure the continuity of high-quality care to home health patients assigned to the team's area in accordance with physician-prescribed plans of care, and all applicable state and federal laws and regulations.
- Receives referrals and ensures appropriate clinician and/or therapist assignments for timely patient evaluation by signing off after authorization and plotting start of care (SOC) visits.
- Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals.
- Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance with physician orders.
- Oversees and assures development, implementation, and updates to the individualized patient plan of care, as appropriate.
- Manages and documents phone calls from physicians, clinicians, patients, referral sources, and communicates patient updates/new orders to clinicians. Uses coordination notes to document, as needed and appropriate.
- Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate.
- Coordinates all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other applicable healthcare providers.
- Follows-up on lab and other clinical diagnostic test, physician contact, and significant changes in the patient condition to ensure adequate physician notification, follow-up, and needed plan of care modifications and communicates such to clinicians.
- Assists clinicians in coordinating the transfer and discharge of patients from agency services as indicated by the physician.
- Receives report from field clinicians prior to scheduled days off on patient status and ongoing needs.
- Processes new orders and updates the visit frequency, as appropriate, when the on-call RN takes supplemental verbal orders which alter frequency going forward.
- Writes and processes orders when taking verbal orders directly from the physician and communicates such to field clinicians.
- Assures payer change documentation is completed properly and timely, as required.
- Reviews clinician visit notes weekly to ensure timely, complete, appropriate, and accurate submission of all documentation by field staff. Takes necessary action to correct adverse findings and communicates trending to clinical director.
- Reviews, evaluates, and supervises service delivery to ensure appropriateness of care and utilization of services, equipment, and supplies through activities such as random patient visits, medical record reviews, and case conferences.
- Enters infections and incidents/occurrences into the online Risk Management Incident Reporting System, as specified by policy.
- Assists in the orientation of new agency personnel.
- Provides direction and leadership to clinical team members in collaboration with the clinical director.
- Provides direct patient care, as necessary, in accordance with scope of practice and physician orders.
- Participates in QAPI program.
- Assures compliance with and ensures timely follow-up on daily clinical and coding edits.
- Directs clinicians in utilizing best practice interventions when finalizing Plan of Care for all patients.
- Participates in on-call rotation.
- Follows-up with On-Call events daily.
- Receives report from weekend and after-hours clinicians admitting new patients.
- Completes LHC required learning courses, additional assignments per Executive Director request, as well as any state-specific required training per state regulation/practice act requirements.
- Directs team in adherence to and participates in the Episode Management process.
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