Team Manager Home Care

About the role

The Team Manager is the leader of the Patient Care Team and is responsible for supervising, evaluating, and coordinating interdisciplinary team members; ensuring continuity of care from admission to discharge or transfer to bereavement; serving as patient advocate and coordinator for external health care providers; and maintaining patient records from intake through discharge or transfer to bereavement.

Responsibilities

• Direct all patient care services for the team, including volunteer and bereavement, ensuring services are integrated into the interdisciplinary plan of care.
• Review pending and new patient admissions, assessments, histories, and “alive” discharges to verify eligibility and appropriateness criteria are met.
• Collaborate with team and attending physicians regarding palliative care measures for pain and symptom management.
• Ensure complete and accurate data and documentation for recertification decisions and timely completion of reviews.
• Review imminent “alive” discharges to ensure effective discharge planning.
• Monitor type and level of team services (staffing, medications, HME, supplies, level of care changes) to ensure appropriateness and responsiveness to patient/family needs.
• Manage team schedule and coordinate services 24/7 for all patients on the team.
• Facilitate team meetings to ensure interdisciplinary input into plan-of-care updates and revisions aligned with patient and family needs.
• Participate in on-call rotation.
• Interview, select, train, supervise, evaluate, and dismiss team staff in conjunction with the Patient Care Administrator.
• Ensure staff competence and performance through field visits, documentation reviews, and team-based in-services on VITAS values, hospice principles, and team growth needs.
• Act as a clinical resource and mentor for staff on clinical issues, documentation, problem-solving, and customer service.
• Oversee staff and volunteer schedules, scheduling, and territory assignments to distribute workload equitably and meet productivity expectations.
• Review and approve payroll, ensuring accurate time, mileage, and expense documentation.
• Monitor clinical records and team activities to ensure accuracy, completeness, and compliance with VITAS policy and regulatory standards.
• Develop and implement performance improvement activities in response to service issues and challenges.
• Ensure completion of proactive and patient/family satisfaction surveys and implement quality improvement measures.
• Assist with surveys and requests from regulatory bodies and intermediaries as directed by local program.
• Perform substantive chart reviews to verify evidence of quality care delivery.
• Participate in Outcomes Management and annual program review.
• Perform utilization review of continuous care and inpatient levels of care for all patients on the team.
• Address patient/family, physician, or MCO grievances and service failures promptly and satisfactorily, escalating as needed.
• Analyze customer service issues on the team to identify root causes and implement improvements.
• Personally engage with patients/families and attending physicians when revocation is considered to seek satisfactory solutions and avoid unnecessary revocations.
• Regularly visit LTC and Contract Bed facilities to ensure care plan integration, customer satisfaction, and criteria discussion.
• Participate in providing inservices to customers and community organizations.
• Verify and approve admitting IPOC diagnosis, treatments, staffing, and supplies.
• Monitor resource utilization to ensure cost-effective service delivery.
• Control and account for productivity, labor, and patient care costs relative to budget.
• Approve all bills and invoices related to patient care services.
• Attend inservices, educational seminars, and workshops to support professional development.
• Develop and achieve professional growth goals and objectives.
• Mentor newly hired Team Managers.

Requirements

• Reliable transportation with appropriate driver’s license and insurance coverage for driver and passengers.
• Private telephone in home.
• Knowledge of primary medical and nursing care principles, with working knowledge of oncologic nursing and palliative care.
• Understanding of interpersonal dynamics within interdisciplinary health care teams and the process of dying and bereavement.
• Working knowledge of VITAS information system (Vx) and ability to utilize management reports.
• Two years of successful supervisory experience or equivalent in a health care organization.

Education

• Bachelor’s degree preferred.
• Current and valid RN license to practice in the state where the VITAS program is located.