RN Patient Care Manager Position Available In Wilson, Tennessee

Job Description:

Job DescriptionThe Home Health Patient Care Manager isresponsible for the overall supervision and coordination ofclinical services. Coordinates and supervises an interdisciplinaryteam of staff to assure the continuity of high quality care to homehealth patients assigned to the team’s area in accordance withphysician prescribed plan of care, and all applicable state andfederal laws and regulations. Receives referrals and ensures appropriate clinician and/ortherapist(s) assignments for timely patient evaluation by signingoff after authorization and plotting start of care (SOC)visits. Coordinates determination of patient home health benefits,medical necessity, and ongoing insurance approvals. Ensures patient needs are continually assessed and carerendered is individualized to patient needs, appropriate andreasonable, meets home health eligibility criteria, and is inaccordance to physician orders. Oversees and assures development, implementation, and updatesto the individualized patient plan of care, asappropriate. Manages and documents phone calls from physicians, clinicians,patients, referral sources, and communicates patient updates/neworders to clinicians. Uses coordination notes to document, asneeded and appropriate. Reviews assessments and plans of care daily, per assignedworkflow, and consults clinicians with recommendations, asappropriate. Coordinates all aspects of care with all disciplines,physicians, durable medical equipment providers, caregivers/familymembers, transferring facilities, and any other applicablehealthcare providers. Follows-up on lab and other clinical diagnostic test, physiciancontact, and significant changes in the patient condition to ensureadequate physician notification, follow-up, and needed plan of caremodifications and communicates such to clinicians. Schedules, prepares for, facilitates, and documents caseconference/SOC reports and facilitates effective exchange ofinformation across disciplines especially with adverse findings,changes in patient condition, daily and urgent updates, asnecessary. Assists clinicians in coordinating the transfer and dischargeof patients from agency services as indicated by thephysician. Receives report from field clinicians prior to scheduled daysoff on patient status and ongoing needs. Processes new orders and updates the visit frequency, asappropriate, when the oncall RN takes supplemental verbal orderswhich alter frequency going forward. Writes and processes orders when taking verbal orders directlyfrom the physician and communicates such to fieldclinicians. Assures payer change documentation is completed properly andtimely, as required. Reviews clinician visit notes weekly to ensure timely,complete, appropriate, and accurate submission of all documentationby field staff. Takes necessary action to correct adverse findingsand communicates trending to clinical director. Reviews, evaluates, and supervises service delivery to ensureappropriateness of care and utilization of services, equipment, andsupplies through activities such as random patient visits, medicalrecord reviews and case conferences. Enters infections and incidents/occurrences into the onlineRisk Management Incident Reporting System, as specified bypolicy. Assists in the orientation of new agency personnel. Provides direction and leadership to clinical team members incollaboration with the clinical director. Provides direct patient care, as necessary, in accordance toscope of practice and physician orders. Participates in QAPI program. Assures compliance with and ensures timely follow up on dailyclinical and coding edits. Directs clinicians in utilizing best practice interventionswhen 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 cliniciansadmitting new patients. Completes LHC required learning courses, additional assignmentsper Executive Director request, as well as any state specificrequired training per state regulation/practice actrequirements. Directs team in adherence to and participates in the EpisodeManagement process. All other duties as assigned. Education & Experience Current RN licensure in state of practice Current CPR certification required Current Driver’s License, vehicle insurance, and access to adependable vehicle or public transportation