Case Manager

Responsibilities

• 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
• Sets up appropriate clinicians for cases
• Makes regular visits to clinical staff to provide guidance and information related to specific issues
• Directs teams to ensure client needs are met and services are provided according to the plan
• Aids clinical staff in establishing priorities, setting goals, and evaluating progress
• Attends case conferences and other clinical meetings to facilitate coordination
• Coordinates 24-hour Agency coverage by Registered Nurses
• Assists in evaluating the quality of on-call coverage
• Provides support and direction to Agency staff, other health care professionals, clients, and families related to appropriate and available health care
• Trains Agency staff on clinical services, policies, and procedures
• Facilitates problem-solving sessions to enable Field Staff to resolve client and/or reimbursement source issues
• Stays current on available community resources, health care costs, and industry trends through self-education and access to outside educational resources
• Ensures accuracy, completeness and timeliness of clinical documentation in accordance with Agency policies and procedures, regulatory requirements and industry standards
• Makes regular reviews of monthly team members' productivity
• Evaluates the quality of on-call coverage
• 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 Plan
• Interprets and enforces human resource policies and procedures in a fair and consistent manner
• Follows Agency guidelines for disciplinary actions
• Completes all mandatory and regulatory training programs

Qualifications

• Graduate of an accredited school of professional nursing
• Minimum of two (2) years management experience in Home Health or related health care organization
• Credential/Licensure: 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: 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