Humana Inc
Overview
Become a part of our caring community and help us put health first. The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel.
Responsibilities
Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed.
Conducts and delegates the assessment and reassessment of patients, including updating care plans and interpreting patient needs, while adhering to Company, physician, and health facility procedures/policies.
Manages the assignment of caregivers.
Oversees the delivery of care to all patients served by the location. Receives case referrals, reviews patient information to determine home health or hospice needs, ensures admission criteria are met, and assigns clinicians to cases as needed.
Instructs and guides clinicians to promote effective performance and delivery of quality home care services; available during operating hours to assist as appropriate.
Assists clinicians in establishing immediate and long-term therapeutic goals, setting priorities, and developing the patient Plan of Care (POC).
Monitors cases for regulatory and payer documentation compliance; ensures final audits/billing are completed timely in accordance with Medicare regulations.
Coordinates communication among team members, attending physicians, and caregivers to ensure appropriate care and outcome planning.
Works with the Branch Director and Company Finance Department to establish location revenue and budget goals.
Participates in sales and marketing initiatives.
Supervises all clinical employees at the location; directs, coordinates, and evaluates staff in line with Company policies and procedures.
Handles employee corrective action and discipline, in collaboration with Human Resources and executive leadership.
Participates in interviewing, hiring, training, and development of direct care clinicians; evaluates performance against goals and requirements; coaches staff and supports in-service education as needed.
Assesses staff education needs based on clinical documentation review and Utilization Review feedback; develops and conducts regular staff education as needed.
Analyzes situations, identifies problems, and evaluates alternatives using Performance Improvement principles.
Reviews case management and clinical staff documentation (starts-of-care, re-certifications, etc.) for appropriateness of care and documentation compliance.
Oversees QA/PI activities; collaborates with Utilization Review on data tracking for performance and outcomes, and supports efficiency and effectiveness of the case management system.
Provides direct patient care only in times of emergency.
Acts as Branch Director in its absence.
Interprets Company standards and policies to ensure regulatory compliance and that caregiver documentation meets internal standards.
Participates in performance improvement activities and maintains ongoing clinical knowledge through training; shares interpretation and direction with staff.
Maintains relationships with referral sources and participates in professional organizations; conducts care-related programs.
Performs other related duties as assigned or requested.
Required Experience/Skills
Graduate of an accredited School of Nursing.
Current state license as a Registered Nurse.
Proof of current CPR.
Valid driver’s license, auto insurance and reliable transportation.
Two years as a Registered Nurse with at least one year of management experience in a home care, hospice or equivalent environment.
Scheduled Weekly Hours 40
Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$114,300 - $157,200 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources
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Responsibilities
Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed.
Conducts and delegates the assessment and reassessment of patients, including updating care plans and interpreting patient needs, while adhering to Company, physician, and health facility procedures/policies.
Manages the assignment of caregivers.
Oversees the delivery of care to all patients served by the location. Receives case referrals, reviews patient information to determine home health or hospice needs, ensures admission criteria are met, and assigns clinicians to cases as needed.
Instructs and guides clinicians to promote effective performance and delivery of quality home care services; available during operating hours to assist as appropriate.
Assists clinicians in establishing immediate and long-term therapeutic goals, setting priorities, and developing the patient Plan of Care (POC).
Monitors cases for regulatory and payer documentation compliance; ensures final audits/billing are completed timely in accordance with Medicare regulations.
Coordinates communication among team members, attending physicians, and caregivers to ensure appropriate care and outcome planning.
Works with the Branch Director and Company Finance Department to establish location revenue and budget goals.
Participates in sales and marketing initiatives.
Supervises all clinical employees at the location; directs, coordinates, and evaluates staff in line with Company policies and procedures.
Handles employee corrective action and discipline, in collaboration with Human Resources and executive leadership.
Participates in interviewing, hiring, training, and development of direct care clinicians; evaluates performance against goals and requirements; coaches staff and supports in-service education as needed.
Assesses staff education needs based on clinical documentation review and Utilization Review feedback; develops and conducts regular staff education as needed.
Analyzes situations, identifies problems, and evaluates alternatives using Performance Improvement principles.
Reviews case management and clinical staff documentation (starts-of-care, re-certifications, etc.) for appropriateness of care and documentation compliance.
Oversees QA/PI activities; collaborates with Utilization Review on data tracking for performance and outcomes, and supports efficiency and effectiveness of the case management system.
Provides direct patient care only in times of emergency.
Acts as Branch Director in its absence.
Interprets Company standards and policies to ensure regulatory compliance and that caregiver documentation meets internal standards.
Participates in performance improvement activities and maintains ongoing clinical knowledge through training; shares interpretation and direction with staff.
Maintains relationships with referral sources and participates in professional organizations; conducts care-related programs.
Performs other related duties as assigned or requested.
Required Experience/Skills
Graduate of an accredited School of Nursing.
Current state license as a Registered Nurse.
Proof of current CPR.
Valid driver’s license, auto insurance and reliable transportation.
Two years as a Registered Nurse with at least one year of management experience in a home care, hospice or equivalent environment.
Scheduled Weekly Hours 40
Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$114,300 - $157,200 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources
#J-18808-Ljbffr