Workflow Clinical Manager, RN Required

5 days ago


FuquayVarina, NC, United States Wellcare Home Health Inc Full time

The Workflow Clinical Manager is responsible for the daily work functions in all clinical information systems to ensure the care planning, utilization of services, and coordination of care. The focus of Workflow Clinical Manager is to provide clinical systems processes to safeguard patient centered care efficiently, effectively, and with the best possible outcomes. The Workflow Clinical Manager approves/disapproves all patient care plans, new and revised.JOB SUMMARY

The Workflow Clinical Manager is responsible for the daily work functions in all clinical information systems to ensure the care planning, utilization of services, and coordination of care. The focus of Workflow Clinical Manager is to provide clinical systems processes to safeguard patient centered care efficiently, effectively, and with the best possible outcomes. The Workflow Clinical Manager approves/disapproves all patient care plans, new and revised.

PRIMARY JOB DUTIES

Oversees care planning, utilization services and coordination of patient care.

Ensures Home Care Home Base (HCHB) compliance with applicable regulations, policies, procedures, guidelines, and best practice standards.

Ensures effective and accurate utilization of HCHB, staff and resources in patient care delivery that is quality oriented and cost efficient.

Contributes to program effectiveness.

Organizes and performs work effectively and efficiently.

Maintains and promotes customer satisfaction.

1.0 50% QUALITY OF WORK:

1.1 25% Oversees and performs the daily work functions in the clinical information systems as evidenced by:

  • Approves or disapproves patient plan of care based on chart review phone calls and conferences.
  • Makes clinical information system recommendations for efficient and effective utilization of resources to achieve positive outcomes.
  • Recommends additional services to improve efficiency and effectiveness of the Plan of Treatment (IE: Utilization of, Medical Social Worker, Therapy, Palliative care, referral to hospice, etc.).
  • Direct team members in planning interventions and goals which are appropriate to the identified needs of their patients. Promotes fiscally responsible care for patients, reviewing all components of the plan of care to ensure the appropriate resources and services are included.
1.2 20% Ensures HCHB compliance with applicable regulations, policies, procedures, guidelines, and best practice standards as evidenced by:
  • Responds to requests for changes in plans of care, made in between case conference, and determines appropriateness of change(s).
  • Maintains knowledge of Federal, State and accreditation regulations as well as Agency Policy and Procedures.
  • Promotes the delivery of quality home health services by acting as a resource for team members in patient care coordination.
1.3 5% Contributes to program effectiveness as evidenced by:
  • Participates actively in agency initiatives to develop new programs and improve existing programs.
  • Actively participates in the design, implementation, and evaluation of at least one significant agency quality improvement project during each evaluation period.
2.0 30% PRODUCTIVITY/USE OF TIME
  • Maintain workflow processes for clinical operations systems.
  • Responds to internal and external emails/voice mails within 2 hours.
  • Maintains utilization statistics within national best practice benchmarks.
  • Optimizes clinical outcome scores as evidenced by Home Health Compare and its equivalents. Outcomes must not be below 85th percentile of national ranking.
  • Achieves goal for hospitalizations.
3.0 20% MISSION, VISION, VALUES

3.1 10% Maintains and promotes customer satisfaction.
  • Abides by the confidentiality and ethics policies of Well Care Home Health.
  • Promotes a cooperative, cohesive group process dedicated to provision of quality patient care with achievement of best possible outcomes.
  • Working collaboratively and cooperating with all members of the agency.
  • In situational leadership, demonstrates the ability to respond positively to changing circumstances to maximize opportunity or minimize potential problems.
3.2 10% Organizes and performs work effectively and efficiently as evidenced by:
  • Recognizing and performing duties in an independent manner.
  • Accepting personal responsibility for the completion and quality of work outcomes. Utilizes available management data to monitor clinical operations efficiency. Presents a clean and neat appearance in personal attire and one's work area.
  • Reports to work on time and returns promptly from errands, breaks and meals.


JOB SPECIFICATIONS

Education: Graduate from an accredited or approved school of nursing. Bachelors degree preferred.

Licensure / Certification: Current license to practice professional nursing in the State in which supervising staff/care (NC/SC).

Experience: Minimum of two years clinical practice. Minimum one year home health experience preferred. Prior experiences that would encompass clinical, teaching, and supervisory practice within a nursing service organization is preferred.

Essential Technical Skills: Current knowledge of fundamental medical-surgical and home health nursing principles and practice. Knowledge of the principles of adult learning. Knowledge of standards of medical record keeping. Ability to speak clearly and effectively before small and large groups. Ability to communicate, both orally and in writing, and to be literate in the English language.

Interpersonal Skills: Excellent interpersonal skills including the ability to interact and communicate in a professional and tactful manner with coworkers, physicians, patients and families and the general public. Must be flexible and innovative.

Essential Physical Requirements: Ability to stand or sit for extended periods of time.

Essential Mental Requirements: Ability to analyze data in clinical information systems to identify staff and agency learning needs. Ability to systematically assess, plan, implement and evaluate evidence based best practice. Demonstrate long and short-term memory. High level problem solving and reasoning skills to assist staff in patient care planning and problem resolution. Able to prioritize duties, learn new skills and use supportive services appropriately. Must work well independently.

Essential sensory requirements: Ability to use sight to assess, plan, implement and evaluate patient care activities in clinical information systems. Ability to use hearing to communicate with staff.

Exposure to Hazards: Noise, exposure to office equipment and machinery. Requires long periods of computer and chart review. May encounter temperature changes and weather extremes.

Other - Hours of Work: Monday - Friday, weekends and holidays as needed. Occasional need for flexible hours to meet educational needs of staff and the agency.
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