Clinical Consulting Manager (PRN)

NetsmartNorth Little Rock, AR
20hRemote

About The Position

We are seeking a Clinical Consulting Manager with a strong background in Home Health and/or Hospice care to support clinical excellence, quality outcomes, and best practices across post-acute settings. This role is ideal for experienced clinicians who are passionate about care in the home, end-of-life support, interdisciplinary collaboration, and patient-centered care delivery. As a Clinical Consulting Manager, you will partner with clinical teams and organizational leaders to provide guidance, education, and operational support that strengthens care delivery, ensures regulatory compliance, and enhances the patient and family experience across home health and hospice services.

Requirements

  • Associate’s Degree in nursing, social work, physical therapy or another related discipline
  • Active and unrestricted license in related field
  • At least 5 years of progressive clinical management experience
  • At least 2 years case management in home health and/or hospice with progressive experience in Quality Assurance activities
  • In-depth knowledge of condition of participations and conditions of payment; extensive knowledge of regulatory standardized assessment documents and patient care protocols
  • Proficient in Microsoft Office Suite including Excel, PowerPoint, and Word
  • Excellent written and verbal communication and presentation skills are required
  • All applicants for employment must be legally authorized to work in the United States.

Nice To Haves

  • Bachelor of Science in nursing (BSN), social work, physical therapy or another related discipline
  • At least 5 years of progressive post acute clinical management experience in home health and /or hospice
  • At least 2 years quality assurance and/or case management experience in home health and /or hospice
  • In-depth knowledge of home health and / or hospice condition of participations and conditions of payment; extensive knowledge of regulatory standardized assessment documents and post-acute patient care protocols

Responsibilities

  • Perform documentation review on medical records to identify clinical elements for accuracy
  • Perform post-acute home health and or hospice documentation review on medical records to identify clinical elements for accuracy
  • Research and provide comments and recommendations on complex or newly issues home health and or hospice billing regulations
  • Review client information systems for complete and accurate clinical documentation
  • Research and provide comments and recommendations on complex or newly issued billing regulations
  • Conduct weekly calls with the client to present findings and results of the engagement
  • Analyze trends and provide process improvement recommendations for clinical operational processes to improve quality of care and patient outcomes
  • Review documentation associated with focused medical reviews and write appeals for denied services; provide denial support at the Administrative Law Judge (ALJ) level of appeals
  • Participate in cross-team clinical consulting work
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