Manage, supervise, coordinate, evaluate and develop client care teams to ensure quality care delivery and appropriate case management within the agency scope of services and according to agency policy and applicable state, federal and local laws and regulations and the Nurse Practice Act.
Essential Job Functions Duties and Responsibilities
- Manage and direct a team of Nurse Case Managers ensuring safe, effective and appropriate home care services.
- Is available at all times during regular business hours and as needed to provide support and assure quality care delivery to home care clients.
- Receive referrals, determine services required, and agency's ability to meet needs; provide oversight of appropriate clinicians to cases.
- Meet with Case Managers/clinical staff on a regular basis to provide guidance and information related to specific issues. Provide direction to teams to assure that client needs are met and services are provided according to the plan of care. Assist clinical staff in establishing priorities, setting goals, and evaluating progress toward goals.
- Review agency policies and procedures and recommends changes or revisions as needed.
- Provide leadership to team and support staff in identifying agency/client needs and opportunities for quality improvement.
- Assist with marketing, public relations, and discharge planning by participating in departmental meetings.
- Assist quality improvement teams with data collection for the Quality Improvement Plan established by the agency.
- Attend/direct case conferences and other clinical meetings to facilitate coordination of care.
- Collaborate with the Agency Director in establishing budget needs and priorities for the department.
- Coordinate 24-hour Agency coverage by Registered Nurses. Evaluate quality of on-call services.
- Provide on-call backup for Case Managers, as needed.
- Develop working relationships with other health care professionals in the community and families to identify resources available and to ensure access of information to clients.
- Provide support and direction to agency staff, other health care professionals, clients, and families related to appropriate and available health care resources.
- Educate agency staff on clinical services, policies and procedures as needed.
- Facilitate discussions to enable Case Managers and other staff to resolve client and/or reimbursement source issues.
- Stay current on available community resources, health care costs, and industry trends through self-education and access to outside educational opportunities.
- Identify and implement changes in clinical and/or operational practice based on the findings of the Quality Improvement Program.
- Maintain confidentiality in all aspects of the job.
- Perform other duties as assigned.
Data, Documentation and Billing Functions
- Ensure accuracy, completeness, and timeliness of clinical documentation in accordance with agency policies and procedures, regulatory requirements, and industry standards.
- Provide education programs and information regarding appropriate documentation practices.
- Monitor open and closed charts regularly, and participate in the quarterly clinical record reviews.
- Complete all RFA OASIS Data oversight, the accuracy of such data and assures completion of input for billing purposes.
- Review OASIS data collection to assure accuracy and consistency with requirements. Communicate with clinicians and provide training as indicated to achieve compliance with collection and reporting timelines.
- Complete chart audits to review that completion of 485, F2F, AlC, regulatory requirements are met.
- Participate in final billing process and direct support staff as appropriate.
- Interpret and enforce human resource policies and procedures in a fair and consistent manner.
- Assist in the recruitment and selection of personnel.
- Provide on-site supervision to clinical teams per agency policy to ensure that all personnel are performing their work assignments in accordance with acceptable standards. Respond to educational and developmental needs.
- Conduct timely performance evaluations in accordance with agency policy.
- Formally and informally monitor performance of personnel and ensure adjustments/corrections are made by using coaching, counseling, and discipline methods.
- Work with the Administrator and Director of Clinical Services to address staff performance issues including those that may lead to termination. Document all disciplinary actions in accordance with agency policies and legal guidelines.
- Collaborate with Agency Administrator and other clinical management staff to ensure proper staffing of qualified, competent personnel.
Safety and Sanitation Functions
- Promote personal safety and a safe environment for clients and co-workers.
- Demonstrate knowledge of safety/infection control practices by compliance with policies and procedures and regulatory requirements.
- Assess safety of environment and take the initiative to help prevent accidents and promote safety.
- Recognize and respond appropriately to potentially unsafe situations
Required Knowledge, Skills and Abilities
- Must possess the ability to make independent decisions, follow instructions, and accept constructive criticism.
- Must be able to deal tactfully with staff, clients, vendors, government agencies/ personnel, and the general public.
- Must be able to work with ill, disabled, elderly, emotionally upset, and potentially hostile people.
- Knowledge and understanding of the rules, regulations and laws applicable to home health agencies, including Medicare conditions of participation.
- Knowledge of reimbursement sources and documentation requirements within home health care.
- Must be able to speak and write English in a manner that is sufficient for effective communication.
- Excellent oral and written communication skills.
- Must possess leadership ability and willingness to work harmoniously with and supervise and manage personnel.
- Must possess skills in leadership and problem solving.
- Must possess creativity, integrity, and initiative.
- Must be able to provide critical thinking skills to address agency issues.
- Must receive criminal clearance and other required screening prior to employment with the agency.
- Must obtain required health screening and TB clearance (see also physical requirements below).
- First Aid training.
- Red Cross certified CPR training.
- Valid and current drivers' license with appropriate endorsements.
- Must be able to travel locally, including adequate automobile insured in accordance with applicable state law.
Education and Experience
Graduate of accredited school of professional nursing; BSN and PHN certification preferred.
Minimum of two (2) years of nursing experience in an acute care setting or equivalent experience with one (1) year of supervisory experience.
Must possess a current, unencumbered, active license to practice as a Registered Nurse in the state(s) of practice.
All requirements are subject to possible modification to reasonably accommodate individuals with disabilities. Individuals who pose a direct threat or significant risk to the health and safety of themselves or others in the work place will not be considered qualified for employment if physical requirements cannot be eliminated or reduced by reasonable accommodation.