Overview
Responsible for providing remote or on-site Clinical Manager coverage in care centers at the direction of the AVP Clinical. Coordinates with and takes direction from Directors of Operations of assigned care center(s). Responsible for the coordination and provision of quality patient care while demonstrating fiscal responsibility and maintaining the highest standards of care and ensuring compliance with all policies, procedures, and regulatory requirements. This role also accountable for measuring, monitoring, and managing quality of patient care, achievement of key performance indicators and organizational clinical performance.
Responsibilities
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Oversees scheduling activities to ensure patient needs are met. Reviews assignments as appropriate with the Patient Services Coordinator and professional and support staff.
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Oversees payor verification and pre-certification requirements. Communicates with payors and their representatives with updates and responds to requests for information.
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Responsible for review of clinician documentation, including the Oasis data collection, starts of care, recertification, physician orders, daily progress notes and other related documents ensuring appropriateness of care, delivery and documentation requirements are met. Ensures missing, incomplete and/or untimely documentation issues are resolved.
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Provides feedback (recognition and corrective) to clinicians regarding documentation, skills, and behavior.
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Oversees and assists clinicians in establishing immediate and long-term patient goals, setting priorities, and developing Plan of Care (POC). Responsible to oversee the management and delivery of patient care, including utilization management, episode management and patient outcomes. Oversees the assignment of the appropriate clinical pathways and implementation of the plan of care and physicians' orders for patients.
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Oversees the professional staff to ensure timely communication of changes in the patient condition to the physician and receipt of necessary changes in orders. Ensures communication of changes in the plan of care to the appropriate staff.
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Evaluates, and regularly re-evaluates the needs of the patient; initiates, develops, implements, and makes necessary revisions to the patient's plan of care in collaboration with the clinicians providing care.
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May lead regular patient care conferences and promotes coordination and communication of information relevant to the care of the patient to ensure quality of care.
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May provide direct patient care on an infrequent basis and only in times of emergency.
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May be asked to participate in the after-hours on call process, including admin on call, preparing on call schedule, and supporting the on-call process as directed.
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Participates in agency quality assurance activities designed to improve quality and continuity of patient care. Performs chart audits and other activities of data collection.
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Responds to Additional Documentation Requests/Denials as directed by the regulatory affairs department.
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Instructs and guides clinicians to promote effective performance and delivery of quality home care services and is always available during operating hours to assist clinicians as appropriate.
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Assists other disciplines in coordinating activities when necessary, assuming responsibility for continuity, appropriateness and quality of services delivered.
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Participates in the investigation and resolution of patient/family/physician concerns.
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Conducts Clinical Manager training for new hires, provides ad hoc trainings as needed, and acts as a mentor to care center Clinical Mangers.
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Responsible for recommending employment decisions for staff to the Director of Operations, including decisions to hire, fire, advance, promote, or change status.
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Performs other duties as assigned or requested.
Qualifications
Required
- Associate or Bachelor's degree in Nursing.
- Current, unencumbered license to practice as a Registered Nurse specific to that state(s) the employee is assigned to work by the company. May possess either a single state license in each non-compact state and/or a compact license in their state of residence that is accepted in all Nurse License Compact (NLC) participating states.
- One (1+) year of supervisory and/or management experience as a Registered Nurse in a healthcare environment.
- One (1+) year of RN experience in a Home Health or Hospice environment.
- Current CPR certification.
Amedisys is an equal opportunity employer. All qualified employees and applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition or carrier status or any other legally protected characteristic.