A Clinical Manager assists the Director of Clinical Services/Administrator with the supervision of home health services to patients in their place of residence in accordance with physician orders and strives to provide the highest quality of care. Skilled nursing and other therapeutic services furnished are under the supervision of the Clinical Manager. The Clinical Manager is available at all times during operating hours (or appoints a similarly qualified alternate) and participates in all activities relevant to professional services furnished, including the development of qualifications and assignment of personnel.

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Qualifications:

1. Graduate of an approved school of professional nursing and currently licensed in the state(s) in which practicing.
2. Three to five (3 - 5) years of experience in nursing, preferred.
3. One (1) year of experience in home health nursing, preferred.
4. Acceptance of philosophy and goals of Agency.
5. Ability to exercise initiative and independent judgment.
6. Ability to work with individuals to enlist the cooperation of many people to perform/achieve a common goal.
7. Ability to deal effectively with high levels of stress.
8. Ability to assist in evaluating personnel per Agency policy.
9. Ability to supervise, guide, and develop skills and performance of service personnel.

Responsibilities:

1. Understands and adheres to established Agency policies and procedures.
2. Ensures safe and therapeutically effective services to patient/family/caregivers. Assures that patient needs are continually assessed, and assures the development, implementation, and update of individualized plans of care.
3. Ability to supervise, guide, and develop the skill and performance of clinical staff.
4. Oversees the aide competency program and ensures the skill and competency of all aides working for the Agency.
5. Consults with the Director of Nursing/Administrator in determining a staffing pattern which will accomplish stated objectives and promote a maximum level of utilization of health personnel. Makes patient and personnel assignments according to these objectives.
6. Assists in recruiting, hiring, evaluating, and terminating all personnel. Institutes, interprets, and documents disciplinary action.
7. Responsible for the discipline-specific orientation of new patient care personnel.
8. Assists in the planning and consultative needs of staff.
9. Participates in establishing the functions and qualifications for each service position, and coordinates patient care and referrals.

• Assures ongoing assessment of patient/family needs and implementation of interdisciplinary team plan of care.
• Assures physician approval of plans for continuity of care.
• Provides individual or group support concerning job-related stress or issues.

1. Implements policies and procedures which meet Medicare, Medicaid, state and local rules, regulations and laws.
2. Displays a willingness to support policies and procedures and uses appropriate channels for changes of such policies.
3. Assists in the coordination of interdisciplinary team services.
4. Assists in the organization of nursing services to delineate and delegate functional responsibility, lines of relationship and communication to provide safe and therapeutically effective service.
5. Participates in the coordination of Agency’s services with the services of other community agencies.
6. Serves as a role model for all employees by setting an example of high standards in dress, conduct, cooperation, and job performance.
7. Observes confidentiality and safeguards all patient-related information. Maintains HIPAA compliance at all times.
8. Ensures/performs daily audit of clinical notes for completeness, skill, and medical necessity within 48 hours of clinician submission. Maintains target QA Velocity at > 90%.
9. Ensures documentation reflects care that is outcome-driven as evidenced by adherence to established goals for patient performance/improvement on all measures.
10. Ensures all clinician schedules adhere to physician plans of care and coordinates daily visits for the field clinicians, minimizing missed visits. Ensures labs are reviewed and forwarded to physicians or non-physician practitioners as necessary. Ensures follow-up activity takes place to ensure orders are received in a timely manner. Ensures priority attention is given to critical lab results and implements a system to ensure these are communicated to physicians or non-physician practitioners immediately. Ensures lab results are scanned to the EMR.
11. Monitors Final Claim Deficiencies in the EMR and completes End of Episode activities to ensure the accuracy and timeliness of all billing as defined as 15 days or less. Ensures face-to-face documentation meets all regulatory requirements, physician and non-physician practitioner orders are signed, and OASIS validation is present prior to claims release.
12. May enter initial intake information into the Agency EMR as needed to ensure timely scheduling of admission visit.
13. Ensures the Face-to-Face Encounter and Initial Order documentation meets the certification requirements when processing intake information and reviewing the Plan of Care.
14. May communicate with clients/families/physicians/non-physician-practitioners on referral, care and service delivery issues in a professional and competent manner as required by the customer service policies of the Agency.
15. Reviews OASIS assessments for accuracy in coding by using Face to Face Encounter documentation, referral data, and other intake information to accurately code according to standards established by ICD, CMS, and the Agency. 
16. Reviews OASIS documentation in a timely manner, with productivity expectations maintained for QA Velocity at > 90% for appropriateness, congruency, and accuracy as it relates to the Plan of Care while following CMS guidelines.
17. Reviews and approves Plans of Care, Change Orders, Rehabilitation Evaluations and Reassessments. Assists with the development, implementation, and evaluation of patient Plans of Care.
18. Accepts responsibility for regular attendance and punctuality; fulfills job-related requirements without regard to time involved.
19. Serves as a resource person to employees.
20. Investigates and reports any problem relating to patient care and/or employee well-being.
21. Immediately reports any accident, incident, lost articles, or unusual occurrence to the Director of Clinical Services/Administrator.
22. Attends pertinent continuing education programs other than routine in-services and shares information with staff. Ensures effective communication within the branch.
23. Monitors supplies for appropriate use and takes steps to keep misuse to a minimum. Ensures that necessary supplies and equipment are available for patient care.
24. Participates in the agency’s ongoing performance improvement (QAPI) program.
25. Institutes corrective action plans (PIPs) for any deficiency noted as part of the overall Agency Continuous Quality Improvement Plan. May include clinical record review, complaint resolution, occurrence reporting, and staff competency.
26. Reviews patient medical records for compliance with federal, state, local, and agency policies and guidelines.
27. Conducts patient care conferences, staff meetings, and maintains documentation. Participates in community education projects as needed.
28. Submits all reports or other documentation required by the Administrator/Director of Clinical Services in a timely manner and per the established deadline.
29. Must be able to perform nursing functions in times of staff shortage.
30. Responsive to all communication in a timely manner (i.e., email, phone, text).
31. Assists with staffing visit assignments and on-call as needed.
32. Other duties as assigned by the Director of Clinical Services/Administrator.
33. May act as the Director of Clinical Services in her absence. 

Working Environment:

Works indoors in the agency office and patient homes and travels to/from patient homes.

Job Relationships:

1. Supervised by: Director of Nursing/Administrator
2. Workers Supervised: Registered Nurse, Licensed Practical Nurse, Home Health Aide, Medical Social Worker, Registered Physical/Occupational Therapist/Assistant, Speech Language Pathologist

Risk Exposure:

High risk

Lifting Requirements:

• Ability to perform the following tasks if necessary:
• Ability to participate in physical activity.
• Ability to work for an extended period of time while standing and being involved in physical activity.
• Moderate lifting, > 10 lbs.
• Ability to do extensive bending, lifting, and standing on a regular basis.

Phi Usage:

Administrative Authorization: May access any information contained in patient records when required for the purpose of supervising staff or complying with licensing and other regulatory requirements.