Reports directly to the Director of Clinical Services and is responsible for the care coordination of the clinical population and Clinical Case Managers. Responsible for admissions and recertification assessments including supporting documentation as assigned. Ensures compliance with MGA State Federal and policies of accrediting agencies. Responsible for maintaining compliance with all reimbursement guidelines. Participates in program development and implementation.
Duties and Responsibilities
- Under the direction of the Director of Clinical Services plans organizes and manages the provision of patient care and Clinical Case Managers assuring that all patient needs are continually assessed.
- Acts as a firstline manager for designated staff and assures coordination of new referrals and patient care including overseeing the development implementation and updates of the individualized plan of care.
- Day to day management of provider issues and care delivery.
- Contributes to improving quality and consistency of patient care & experience.
- Evaluates quality of care patient satisfaction and compliance and oversee both patient and personnel assignments.
- Facilitates Care Coordination Meetings and provides leadership in problem solving and gives professional advice from a clinical perspective.
- Reviews implements and interprets clinical policies and procedures as directed by DOCS.
- Serves as a clinical lead at relevant clinical and departmental meetings.
- Enforces and demonstrates compliance with all State and Federal regulations.
- Communication with case managers (Statefunded programs Medicaid and thirdparty payors) clinical updates and ensuring continuing authorizations and reverification of eligibility.
- Compliance and participation in the continuing quality improvement and utilization review of organizational services.
- 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 as scheduled in order to complete work within the designated time.
- Adheres to all company policies and procedures outlined in the Employee Handbook Employee Agreement or communicated from Human Resources.
- May be required to maintain a patient caseload.
- Aid in terminations coaching education and counseling of field staff.
- Assist in the management of complaint intakes track and followup.
- Participates in QAPI/PAC as appropriate
Clinical Manager Oversight
- Making patient and personnel assignments;
- Coordinating patient care;
- Coordinating referrals;
- Assuring that patient needs are continually assessed; and
- Assuring the development implementation and updates of the individualized plan of care.
Qualifications :
- Current state license as a Registered Nurse BSN preferred.
- A minimum of 2 years of nursing experience in a Home Health or Acute setting is required.
- Minimum 35 years of clinical management/supervision preferred.
- Demonstrate leadership capabilities with strong supervisory and interpersonal skills.
- Detailoriented flexible good organizational and time management skills.
Additional Information :
Benefits are available to eligible employees on the first of the month after 30 days of employment and include:
- Compensation range of $78000 $82000 annually
- Auto and cell phone allowances
- Health Dental & Vision Coverage
- Health Savings Accounts (HSA)
- Flexible Spending Accounts (FSA)
- Employee Assistance Program (EAP)
- 401(k) retirement plan
- Paid Time Off (PTO)
- Company Paid Holidays
- 100 Company Paid Life Insurance
- Critical Illness/Accident Insurance
- Hospital Indemnity Insurance
- Identity Protection Plan
- Legal Care Plan
All your information will be kept confidential according to EEO guide.
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Remote Work :
No
Employment Type :
Fulltime