Case Manager

Case Manager

Job Summary:

Manages, supervises, coordinates, evaluates, and develops client care teams to ensure quality care delivery and appropriate case management within the Agency scope of services and policies; state, federal, and local laws; and Nurse Practice Act.

• Manages and directs a team of Field staff ensuring safe, effective, and appropriate home care
• Receives referrals, determines services required, and Agency's ability to meet needs. Assigns appropriate clinicians to
• Meets with clinical staff on a regular basis to provide guidance and information related to specific issues. Provides direction to teams to assure that client needs are met, and services are provided according to the plan. Assists clinical staff in establishing priorities, setting goals, and evaluating progress toward
• Attends case conferences and other clinical meetings to facilitate coordination of
• Reviews monthly team members' productivity
• Coordinates 24-hour Agency coverage by Registered Nurses. Evaluates quality of on-call
• Provides on-call backup for Case Managers, as
• Develops working relationships with other health care professionals in the community and families to identify resources available and to ensure access of information to
• Provides support and direction to Agency staff, other health care professionals, clients, and families related to appropriate and available health care
• Educates Agency staff on clinical services, policies, and procedures as
• Facilitates problem-solving sessions to enable Field Staff to resolve client and/or reimbursement source
• Stays current on available community resources, health care costs, and industry trends through self-education and access to outside educational
• Ensures accuracy, completeness and timeliness of clinical documentation in accordance with Agency policies and procedures, regulatory requirements and industry standards.
• Monitors open and closed charts regularly and participates in the quarterly clinical record
• Reviews Agency policies and procedures and recommends changes or revisions as
• Provides educational programs and information regarding appropriate documentation
• Provides leadership to team and support staff in identifying Agency/client needs and opportunities for quality
• Assists quality improvement teams with data collection for the Quality Improvement Plan established by the
• Reviews OASIS data collection to assure accuracy and consistency with requirements. Communicates with clinicians and provides training as indicated to achieve compliance with collection and reporting
• Identifies and implements changes in clinical and/or operational practice based on the findings of the Quality Improvement
• Interprets and enforces human resource policies and procedures in a fair and consistent
• Assists in the orientation of new
• Follows Agency guidelines for disciplinary actions. Documents all disciplinary actions in accordance with Human Resource policies and legal
• Collaborates with Agency Director and other clinical management staff to ensure proper staffing of qualified, competent
• Promotes personal safety and a safe environment for clients and co-workers.
• Demonstrates knowledge of safety/infection control practices by compliance with policies and procedures and regulatory
• Assess safety of environment and takes the initiative to help prevent accidents and promote
• Recognizes and responds appropriately to potentially unsafe
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Educational Requirements:

• Graduate of an accredited school of professional nursing

Experience:

• Minimum of two (2) years management experience in Home Health or related health care organization

Credential/Licensure

Required:

• Graduate of a 4-year medical related degree
• Must be a licensed driver with an automobile that is insured in accordance with state and agency requirements and is in good working order

Special Conditions of Employment:

• Drug test
• Initial and continuous exclusion and sanction/disciplinary monitoring
• Any and all additional eligibility requirements based on the specific position

Required Training:

• HIPAA Privacy Course
• HIPAA Security Course

Job Skill Requirements:

• Knowledge of home care federal and state
• Knowledge of reimbursement sources and documentation requirements within home health
• Excellent written and verbal communication skills and strong interpersonal skills including the ability to market and relate tactfully with customers and other members of the

Behavioral Traits:

• Intuitive/Open minded:
  Must be able to see opportunities, develop and implement creative solutions to complex problems
• Achievement Drive/Commitment:
  Driven to achieve goals, objectives, and results. Fosters a culture of continuous improvement
• Positive/Supportive:
  Inspires and shows faith in others, builds a positive and supportive work environment
• Flexibility:
  Ability to adapt to changing business needs. To balance multiple priorities and deliver under pressure

Seniority Level: Mid-Senior level

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