RN Patient Care Manager

Primary Responsibilities

• Receives referrals and ensures appropriate clinician and/or therapist(s) assignments for timely patient evaluation by signing off after authorization and plotting start of care (SOC) visits
• Captures determination of patient home health benefits, medical necessity, and ongoing insurance approvals
• Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance to physician orders
• Oversees and assures development, implementation, and updates to the individualized patient plan of care, as appropriate
• Manages and documents phone calls from physicians, clinicians, patients, referral sources, and communicates patient updates/new orders to clinicians
• Uses coordination notes to document, as needed and appropriate
• Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate
• Coordinates all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other applicable healthcare providers
• Schedules, prepares for, facilitates, and documents case conference/SOC reports and facilitates effective exchange of information across disciplines especially with adverse findings, changes in patient condition, daily and urgent updates, as necessary
• Coordinates the transfer and discharge of patients from agency services as indicated by the physician
• Schedules, prepares for, facilitates, and documents case conference/SOC reports and facilitates effective exchange of information across disciplines especially with adverse findings, changes in patient condition, daily and urgent updates, as necessary
• Coordinates all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other applicable healthcare providers
• Follows-up on lab and other clinical diagnostic test, physician contact, and significant changes in the patient condition to ensure adequate physician notification, follow-up, and needed plan of care modifications and communicates such to clinicians
• Reviews clinician visit notes weekly to ensure timely, complete, appropriate, and accurate submission of all documentation by field staff
• Takes necessary action to correct adverse findings and communicates trending to clinical director
• Reviews, evaluates, and supervises service delivery to ensure appropriateness of care and utilization of services, equipment, and supplies through activities such as random patient visits, medical record reviews and case conferences
• Enters infections and incidents/occurrences into the online Risk Management Incident Reporting System, as specified by policy
• Aids in the orientation of new agency personnel
• Provides direction and leadership to clinical team members in collaboration with the clinical director
• Participates in QAPI program
• Affirms compliance with and ensures timely follow up on daily clinical and coding edits
• Directs clinicians in utilizing best practice interventions when finalizing Plan of Care for all patients
• Participates in on-call rotation
• Follows-up with On-Call events daily
• Receives report from weekend and after-hours clinicians admitting new patients
• Completes LHC required learning courses, additional assignments per Executive Director request, as well as any state specific required training per state regulation/practice act requirements
• Directs team in adherence to and participates in the Episode Management process

Required Qualifications

• Current RN licensure in state of practice
• Current CPR certification
• Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation

State Specific Requirements

• RN licensure must have no restrictions

Pay and Benefits

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

The salary for this role will range from $72,800 to $130,000 annually based on full-time employment.

We comply with all minimum wage laws as applicable.