RN Clinical Manager, Home Health - Clinic
Company: Humana Inc
Location: Buffalo Grove
Posted on: September 13, 2023
RN Clinical Manager, Home HealthDescription
Remote opportunity available.
RN must have Home Health and Oasis experience.
The Clinical Manager coordinates and oversees all direct care
patient services provided by clinical personnel.
* Develops, plans, implements, analyzes, and organizes clinical
operations for a specific location managed.
* Conducts/delegates the assessment and reassessment of patients,
including updating of care plans and interpreting patient needs,
while adhering to Company, physician, and/or health facility
* Manages the assignment of caregivers.
* Responsible for and oversees the delivery of care to all patients
served by the location. Receives case referrals. Reviews available
patient information related to the case, including disciplines
required, to determine home health or hospice needs. Accountable to
ensure patients meet admission criteria and make the decision to
admit patients to service. Assigns appropriate clinicians to a
case, as needed.
* Instructs and guides clinicians to promote more effective
performance and delivery of quality home care services, and is
available at all times during operating hours to assist clinicians
* Assists clinicians in establishing immediate and long-term
therapeutic goals, in setting priorities, and in developing patient
Plan of Care (POC).
* Monitors cases to ensure documentation is in compliance with
regulatory agencies and requirements of third-party payers. Ensures
final audits/billing are completed timely and in compliance with
* Coordinates communication between team members/attending
physicians/caregivers to ensure the appropriateness of care and
* Works in conjunction with the Branch Director and Company Finance
Department to establish location's revenue and budget goals.
* Participates in sales and marketing initiatives.
* Supervises all clinical employees assigned to a specific
location. Responsible for the overall direction, coordination, and
evaluation of the location. Carries out supervisory
responsibilities in accordance with Company policies and
* Handles necessary employee corrective action and discipline
issues fairly and objectively, in consultation with the Human
Resources Department and the Executive Director/Director of
* Participates in the interviewing, hiring, training, and
development of direct care clinicians. Evaluates their performance
relative to job goals and requirements. Coaches staff and
recommends in-service education programs, when needed. Ensures
adherence to internal policies and standards.
* Assesses staff education needs based on own the review of
clinical documentation in addition to feedback and recommendations
by Utilization Review staff. Upon completion of the assessment,
creates and conducts regular staff education as needed.
* Analyzes situations, identifies problems, identifies and
evaluates 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 the QA/PI activities. Works 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 performs patient care assignments and staff management
* Provides direct patient care on an infrequent basis and only in
times of emergency.
* Acts as Branch Director in his/her absence.
* Interprets Company standards and Company policies and procedures
to ensure compliance with external regulatory authorities and
ensures that caregiver clinical documentation meets internal
* Participates in performance improvement activities, maintains
ongoing clinical knowledge through internal and external training
programs. Provides interpretation of knowledge and direction to
* Maintains relationships with referral/community sources.
Participates in professional organizations and conducts
* Performs other related duties as assigned or requested.
* 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
* Two years as a Registered Nurse with at least one-year of
management experience in a home care, hospice or equivalent
Scheduled Weekly Hours
Keywords: Humana Inc, Buffalo Grove , RN Clinical Manager, Home Health - Clinic, Executive , Buffalo Grove, Illinois
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