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Clinical Manager
2 months ago
We are seeking a highly skilled and experienced Clinical Manager to join our team at CenterWell Home Health. As a Clinical Manager, you will play a critical role in overseeing the delivery of high-quality patient care and ensuring the success of our home health services.
Key Responsibilities- Develop and implement clinical operations for a specific location, ensuring compliance with regulatory requirements and Company policies.
- Conduct assessments and reassessments of patients, updating care plans and interpreting patient needs to ensure effective care delivery.
- Manage the assignment of caregivers, ensuring the right staff are in place to meet patient needs.
- Oversee the delivery of care to all patients served by the location, receiving case referrals and reviewing patient information to determine home health or hospice needs.
- Assign appropriate clinicians to cases, as needed, and instruct and guide them to promote effective performance and delivery of quality home care services.
- Monitor cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers, ensuring final audits and billing are completed timely and in compliance with Medicare regulations.
- Coordinate communication between team members, attending physicians, and caregivers to ensure the appropriateness of care and outcome planning.
- Work with the Branch Director and Company Finance Department to establish location revenue and budget goals, participating in sales and marketing initiatives.
- Supervise all clinical employees assigned to a specific location, responsible for the overall direction, coordination, and evaluation of the location.
- Handle employee corrective action and discipline issues fairly and objectively, in consultation with the Human Resources Department and the Executive Director/Director of Operations.
- Participate in the interviewing, hiring, training, and development of direct care clinicians, evaluating their performance relative to job goals and requirements.
- Analyze situations, identify problems, and evaluate 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 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 perform patient care assignments and staff management activities, providing direct patient care on an infrequent basis and only in times of emergency.
- Act as Branch Director in his/her absence, interpreting Company standards and Company policies to ensure compliance with external regulatory authorities and ensuring that caregiver clinical documentation meets internal standards.
- Participate in performance improvement activities, maintaining ongoing clinical knowledge through internal and external training programs, providing interpretation of knowledge and direction to staff.
- Maintain relationships with referral/community sources, participating in professional organizations and conducting care-related programs.
- Graduate of an accredited School of Nursing.
- Current state license as a Registered Nurse.
- Proof of current CPR.
- Valid driver's license, auto insurance, and reliable transportation.
- Two years as a Registered Nurse with at least one-year of management experience in a home care, hospice, or equivalent environment.
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 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.
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.
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.
