Clinical Consulting Manager (Home Health and Hospice) PRN

Netsmart • North Little Rock, AR

1d • Remote

About The Position

Netsmart is 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. The role partners 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.

The position requires comfort with remote work arrangements and virtual collaboration tools. It may involve extended or irregular hours outside traditional office hours to support clients and projects across multiple time zones, as well as travel up to 25% as needed. Physical demands include extended periods of sitting, computer use, and telephone communication.

Requirements

• Associate’s degree in nursing, social work, physical therapy, or another related discipline.
• Active and unrestricted license in a related field.
• At least 5 years of progressive post-acute clinical management experience in home health and/or hospice.
• Experience with case management in home health and/or hospice, with progressive involvement in Quality Assurance activities.
• In-depth knowledge of conditions of participation and conditions of payment, regulatory standardized assessment documents, and patient care protocols.
• Proficiency in Microsoft Office Suite, including Excel, PowerPoint, and Word.
• Excellent written and verbal communication and presentation skills.
• Legally authorized to work in the United States; Netsmart does not provide work visa sponsorship for this position.
• Successful completion of a pre-employment background check, including a drug screen, is required for post-offer candidates.

Nice To Haves

• Bachelor of Science in nursing (BSN), Master of Social Work (MSW), physical therapy, or another related discipline.
• Experience with Medicare contractor audits and appeals.

Responsibilities

• Review medical records and documentation to identify clinical elements requiring accuracy.
• Review post-acute home health and/or hospice documentation for clinical accuracy.
• Research complex or newly issued home health and/or hospice billing regulations and provide comments and recommendations.
• Review client information systems for complete and accurate clinical documentation.
• Conduct weekly client calls to present engagement findings and results.
• Analyze trends and recommend process improvements to 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.

What This Job Offers

• Career Level: Manager
• Education Level: Associate degree