Clinical Care Manager

SUMMARY

Responsible for providing oversight, coordination and management of the intake process for Home and Community Based Services. The role ensures high quality, compassionate care is coordinated to be delivered in alignment with Sholom's philosophy of person-centered care, regulatory standards, and patient centered goals. This position includes providing leadership in the management of the processes from referral to intake, to ongoing treatment, ensuring seamless transitions and continuity of care. The Clinical Manager is responsible for establishing and maintaining positive relationships with customers and referral sources, educating staff on regulatory requirements and providing guidance on complex cases. This position is responsible for responding to customer requests and concerns, managing the insurance verification and authorization processes and assigning staff to referrals

PRIMARY RESPONSIBILITIES

• Directs patient referrals and intake operations including providing direct oversight of the establishment and implementation of intake processes and policies.
• Ensures compliance with all state, federal referral/intake regulatory requirements.
• Establishes and maintains positive working relationships with current and potential referral sources.
• Ensures seamless transition of patients to home care and hospice by providing coordination of care between referrals source and home care and hospice programs.
• Ensures maximum third party reimbursement through direct oversight of insurance verification and authorization processes.
• Participates in the clinical admissions process, ensuring timely admissions and transitions of care occur per regulation.
• Acts as Home Care and Hospice Case Manager as census directs and as needed.
• Maintains daily/weekly home care and hospice clinical schedules in conjunction with all clinical staff including but not limited to Case Managers to maintain compliance and ensure positive resident outcomes.
• Mentors and supports staff, fostering a collaborative team-based approach to care delivery.
• Completes monthly triple check for the billing process to ensure all documentation is completed in the record prior to billing in conjunction with office coordinators.
• Assists the HCBS leadership team in the preparation of an annual budget for the intake department and monitors allocation of resources according to budgetary limitations.
• Assists in the development of HCBS: homecare and hospice policies, procedures, and implementation of them.
• Assists as need with recruiting, orientation, and provides direct leadership and performance management for members of the office coordinator team.
• Builds and monitors community and customer perceptions of the agency as a high quality provider of services.
• Gathers, collates, and reports referral statistics including key customer referral trends.
• Perform miscellaneous projects and complete various tasks as requested by management.
• Participate in education programs, including requirements specific to Home Care and Hospice.

JOB SPECIFICATIONS

• Must be licensed as Registered Nurse in the State of Minnesota and must maintain licensure.
• Three (3) years' experience in health care management preferred preferably in home and hospice care operations.
• Supervisory experience directing professional and administrative staff preferred.
• CPR/First Aid certified required.
• Possesses a valid driver's license with good driving record, and proof of valid insurance. Must have reliable transportation.

Knowledge, Skills and Abilities

• Demonstrated ability to supervise and direct professional and administrative personnel.
• Ability to market aggressively and manage tactfully with customers and the community.
• Knowledge of corporate business management and governmental regulations.
• Demonstrated positive and effective communication, customer service and public relation skills.
• Ability to demonstrate autonomy, organization, assertiveness, flexibility and cooperation in performing job responsibilities.
• Able to uphold the rights of the individual hospice patients.
• Able to plan, prioritize, coordinate, and manage own work. Able to work unsupervised, make decisions and solve routine problems independently, effectively and creatively.
• Self-motivated, fast learner shows initiative, willing to seek out patient needs and meet them.
• Understand and maintain confidential nature of organization and client information, including and in accordance to HIPAA regulations.
• Work as an effective and proactive team-player; understand the importance of supporting the organization, patients, customers and other Sholom employees.
• Able to display high levels of customer service, responding promptly and thoroughly to the inquiries and needs of individuals both internal and external to the organization in accordance with our PROUD standards.
• Able to assist residents with mobility needs such as transfers, ambulation, escorts or use of assistive devices. Follow established safety protocol and use proper body mechanics.
• Able to follow Sholom safety guidelines in all duties and responsibilities.
• Able to follow proper safety protocol when using cleaning chemicals.
• Practice good body mechanics in all aspects of the work.
• Follow and adhere to Universal Precautions and Infection Control procedures.
• Basic computer skills, such as Microsoft Word, Excel and Outlook.

PHYSICAL REQUIREMENTS NECESSARY TO PERFORM THIS JOB

Incumbent must be able to:

• Perform heavy work, lifting up to 50 pounds.
• Push/pull clients in wheelchairs up to 150 pounds a distance of several feet.
• Hear, speak and effectively verbally communicate, including following oral and written instructions, in order to communicate with people inside and outside the organization.
• Twist, turn, bend, stoop, kneel, squat and reach frequently in the performance of client assistance responsibilities.
• Frequently stand and walk.
• Perform repetitive movements of the upper extremities.
• Exert moderate physical energy for up to eight hours per day.
• Apply manual dexterity for using and maintaining tools and equipment.
• Work a flexible work schedule, nights and weekends as required including attending events/meetings as needed.

TOOLS AND EQUIPMENT USED

Incumbent must be able to use communication devices, medical equipment, patient assistive equipment, walkers, wheelchairs, electric wheelchairs, telephone, copy machines, computers, and medical equipment such as thermometers, blood pressure equipment, oxygen tanks, laundry equipment, cleaning and other equipment.

This job description does not necessarily list all the functions or accountabilities of the job. Employees may be asked by management to perform additional duties and tasks. Management reserves the right to revise and update job descriptions at any time.

Sholom is dedicated to the health and safety of its residents, family members, and team members. All offers of employment are contingent upon successful completion of relevant background, employment verification and TB tests, and using designated PPE where and when required.

Sholom is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.