Job Description

The Clinical 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, as assigned. In addition to client care coordination, this position is responsible for the clinical education of staff. This position ensures compliance with MGA policies, state policies and procedures, and policies of accrediting agencies, as well as responsible for maintaining compliance with all reimbursement guidelines and maintaining patient confidentiality/HIPAA guidelines. Furthermore, individual will participate in program development, implementation, as well as collaborating with Client Service Managers to acquire/develop new relationships with referral and community resources.

** Duties and Responsibilities**

• Instruct, train, and educate on clinical skills/procedures during the final hire and ongoing as issues arise with a focus on the professional development of field staff.
• 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.
• Responsible for direct supervision of field LPNs/RNs per State guidelines.
• Provides support, guidance, and education to patients/patient families and or caregivers to maintain optimal physical and emotional well-being.
• Communicates all occurrences and other pertinent information to the Director of Clinical Services.
• Ensures any observed or suspected patient abuse, neglect, or exploitation is reported to proper authorities as mandated as a health professional.
• Collaborates with the Director of Clinical Services to resolve client/clinical concerns in timely manner.

** Office Responsibilities to Ensure and/or Facilitate the following:**

• Completes onboarding comprehensive clinical skill validations in lab setting and home environment ensuring that clinical practice protocols and standards of practice are followed.

• Reviews clinical documentation to ensure it is complete

• Develops and implements the treatment plan for each patient under the direction of physician. Assuring the development, implementation, and updates of the individualized plan of care are continually assessed to reflect changes in client care.

• Completes all clinical documentation in timely manner, including admissions, recertifications, and resumptions of care, accurately and ensures that documentation meets all requirements per agency policies and State regulations.

• Reviews clinical documentation to ensure it is complete and reflects skilled services to meet payer source requirements for reimbursement.

• Interviews and evaluates potential clinical field staff to ensure competency to promote appropriate/safe patient care and assists with patient and personnel assignments.

• Complies and participates in the continuing quality improvement by appropriately reporting of incidents, injuries, infection, and all components of the risk management program.

• Participates in agency sponsored continuing education in-services and conferences to maintain own clinical competency.

• Supports and executes the mission, ethics, and goals of the company effectively.

• Represents themselves in a positive and professional manner in the company and community.

• * Adheres to dress code with a clean and neat professional appearance.
  

  • Reports on time and as scheduled in order to complete work within designated time.
  • Adhere to all company policies and procedures outlined in Employee Handbook, Employee Agreement, or communicated from executive team.

Qualifications

• Current state license as a Registered Nurse
• Current CPR card and Current health certificate as applicable.
• Current state driver’s license and automobile insurance.
• Previous experience with coaching, mentoring and validating clinical performance preferred
• A minimum of two years of nursing experience in a Home Care or Acute setting is preferred.
• Experience with Tracheostomy and pediatric populations required
• Demonstrate leadership capabilities with strong supervisory and interpersonal skills.
• Detail-oriented, flexible, good organizational and time management skills.
• Knowledge of cost management for clinical services.

Additional Information

Benefits are available to eligible employees on the first of the month after 30 days of employment and include:

• Health, Dental & Vision Coverage
• Health Savings Accounts (HSA-available if enrolled in a high deductible plan)
• Flexible Spending Accounts (FSA & LPFSA)
• Dependent Care Reimbursement Accounts (DCRA)
• Employee Assistance Program (EAP-available if enrolled in Health plan)
• 401(k) retirement plan
• Paid Time Off (PTO)
• 100% Company Paid Basic Life Insurance (if enrolled in Health plan)
• Voluntary Life Insurance
• Short & Long-Term Disability
• Critical Illness/Accident Insurance
• Hospital Indemnity Insurance
• Identity Protection Plan
• Legal Care Plan
• Pet Discount Program

All your information will be kept confidential according to EEO guidelines.

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