Overview Registered Nurse (RN) Clinical Case Manager. The RN Case Manager reports directly to the Director of Clinical Services and is responsible for care coordination of clinical staff and patient/family clientele. Responsible for admissions and recertification assessments, including supporting documentation. This position ensures compliance with MGA policies, state policies and procedures, and policies of accrediting agencies, and is responsible for maintaining compliance with all reimbursement guidelines and maintaining patient confidentiality/HIPAA guidelines. The individual will participate in program development and implementation, as well as collaborating with Client Service Managers to acquire and develop new relationships with clientele.
Responsibilities
Ensures supervision of all home care personnel, as assigned.
Enforces/demonstrates compliance with state/federal regulations.
Ensures effective communication to coordinate the implementation of each patient’s Plan of Care.
Instructs, trains, and re-educates on clinical skills/procedures when necessary.
Responsible for direct supervision of field LVNs/LPNs/RNs per state guidelines.
Provides support, guidance, and education to patients/patient families and/or caregivers to maintain optimal physical and emotional wellbeing.
Communicates all occurrences and other pertinent information to the Director of Clinical Services.
Ensures any observed or suspected child/adult abuse, neglect, or exploitation is reported to proper authorities as mandated health professionals.
Collaborates with Clinical Supervisor and Director of Clinical Services to resolve client/clinical concerns in timely manner.
Office Responsibilities
Develops and implements the treatment plan for each patient under the direction of physician.
Completes all clinical documentation in a timely manner, including admissions, recertifications, resumptions of care; ensures documentation meets agency policies and state regulations.
Reviews clinical documentation to ensure it reflects skilled services for payer reimbursement requirements.
Interviews and evaluates potential clinical field staff to ensure competency for safe patient care.
Participates in quality improvement and risk management reporting.
Participates in agency-sponsored continuing education in-services to maintain clinical competency.
Supports and executes the mission, ethics, and goals of the company.
Represents themselves professionally in the company and community.
Adheres to dress code, punctuality, and all company policies and procedures.
Clinical Manager Oversight
Making patient and personnel assignments
Coordinating patient care
Coordinating referrals
Ensuring ongoing assessment of patient needs
Developing, implementing, and updating the individualized plan of care
Qualifications
Current state license as a Registered Nurse; BSN preferred
Minimum of two years of nursing experience in a Home Health or Acute setting preferred
Current CPR card and health certificate as applicable
Compensation and Benefits
Base salary 90,000-105,000 plus allowances
Health, Dental & Vision Coverage
Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA)
Dependent Care Reimbursement, Employee Assistance Program
401(k) retirement plan
PTO
Company-paid life insurance and voluntary coverage
Short & Long-Term Disability
Critical Illness/Accident Insurance
Hospital Indemnity Insurance
Identity Protection Plan
Legal Care Plan
Pet Discount Program
All information kept confidential according to EEO guidelines.