Pediatric Clinical Case Manager - RN

MGA Homecare•Tucson, AZ

About The Position

The Pediatric Clinical Case Manager - RN is responsible for the supervision of home care personnel, ensuring compliance with regulations, and effective communication to coordinate patient care. This role involves providing support, guidance, and education to patients and their families, as well as direct supervision of field nurses. The position also includes office responsibilities such as developing treatment plans, completing clinical documentation, reviewing documentation for reimbursement, interviewing and evaluating field staff, and participating in quality improvement initiatives. The Clinical Manager provides oversight for patient and personnel assignments, care coordination, referral coordination, continuous patient needs assessment, and the development and updating of individualized care plans.

Requirements

Current state license as a Registered Nurse
Minimum of two years of nursing experience in a Home Health or Acute setting preferred.
Demonstrate leadership capabilities with strong supervisory and interpersonal skills.
Detail oriented, flexible, good organizational and time management skills.
Knowledge of cost management for clinical services.
Current CPR card
Current health certificate as applicable.
Current state driver’s license
Automobile insurance.

Nice To Haves

BSN preferred
Home Health or Acute setting experience preferred.

Responsibilities

Ensures supervision of all home care personnel, as assigned.
Enforces/ demonstrates compliance with State/ Federal regulations.
Ensures effective communication to coordinate the implementation of each patient’s Plan of Care.
Instruct, train, and re-educate on clinical skills/procedures when necessary.
Responsible for direct supervision of field LVNs/LPNs/RNs per State guidelines.
Provides support, guidance, and education to patients/patient families and or caregivers to maintain optimal physical and emotional wellbeing.
Communicates all occurrences and other pertinent information to the Clinical Supervisor/Director of Clinical Services.
Ensures any observed or suspected child/adult abuse, neglect, or exploitation is reported to proper authorities as mandated as a health professional.
Collaborates with Clinical Supervisor and Director of Clinical Services to resolve client/clinical concerns in a timely manner.
Develops and implements the treatment plan for each patient under the direction of physician.
Completes all clinical documentation in timely manner, including admissions, recertification’s, resumptions of care, accurately and ensures that documentation meets all requirements per agency policies and State regulations.
Reviews clinical documentation to ensure it is complete and reflects skilled services to meet payer source requirements for reimbursement.
Interviews and evaluates potential clinical field staff to ensure competency in order to promote appropriate/safe patient care.
Complies and participates in the continuing quality improvement by appropriately reporting of incidents, injuries, infection and all components of the risk management program.
Participates in agency sponsored continuing education in-services and conferences to maintain own clinical competency.
Supports and executes the mission, ethics, and goals of the company effectively.
Represents themselves in a positive and professional manner in the company and community.
Adheres to dress code with a clean and neat professional appearance.
Reports on time and as scheduled in order to complete work within designated time.
Adheres to all company policies and procedures outlined in Employee Handbook, Employee Agreement, or communicated from executive team.
Making patient and personnel assignments.
Coordinating patient care.
Coordinating referrals.
Assuring that patient needs are continually assessed.
Assuring the development, implementation, and updates of the individualized plan of care.