About The Position

This role will assist in the management of daily operations of an interdisciplinary care team, ensuring the delivery of outcome-based, cost-effective care through metric-driven decisions. The primary purpose is to oversee all patient care services and personnel for their assigned team, collaborating with team members to achieve exceptional outcomes. This includes assuring the development of personnel qualifications and policies, identifying and facilitating professional development needs and competency of staff through home visits, and maintaining compliance with regulatory agency policies and procedures. The role involves providing staff guidance in making clinical and case management decisions that are cost-effective and focused on clinical outcomes. Accountability for team performance in achieving desired clinical and operational performance measures is key. The role utilizes clinical software to identify opportunities for education, most appropriate utilization of services, oversee clinical progression of patients, and trend team outcomes and performance. Assures that clinical and functional outcomes are achieved at the highest level possible. Resolves patient care problems collaboratively with internal/external customers and peers across regions. Oversees daily patient assignments for clinical staff based on client needs and staff competency to maintain team productivity standards using LEAN Daily Management processes. Coordinates referrals and ensures timeliness of SOCs and adjunct service delivery. Ensures continuous assessment of patient needs and the development, implementation, and updating of individualized plans of care. Coordinates patient care, including communication with all physicians involved. Determines staffing needs and coordinates hiring to meet service demands for assigned geographic areas. Hires, trains, coaches, and evaluates staff, completing personnel evaluations according to agency timelines. Reviews and analyzes team and patient metrics to align with agency initiatives. Participates in preceptor programs, anticipates customer needs, and responds quickly, accurately, and pleasantly. Actively participates in the performance improvement process plan (H3W), huddles, IDT, and the agency QAPI Program. Performs other duties as assigned.

Requirements

  • Associate degree Registered Nurse required.
  • Field experience as Home Health or Hospice clinician required.
  • Registered nurse with current license to practice in the state of CT required.
  • Bachelor’s degree in one of the therapy disciplines required.
  • Minimum of 5 years clinical experience required.
  • Home health experience required.
  • Current CT licensure as a PT, OT or ST required.

Nice To Haves

  • Bachelor’s degree in nursing preferred.
  • OASIS and case management certification preferred.
  • Master’s degree in PT, OT, ST preferred.
  • Prior supervisory experience preferred.
  • OASIS & case management certification preferred.

Responsibilities

  • Assist in management of daily operations of an interdisciplinary care team.
  • Ensure the delivery of outcome-based, cost-effective care by utilizing metric-driven decisions.
  • Oversee all patient care services and personnel for their assigned team.
  • Collaborate with all team members to achieve exceptional outcomes.
  • Assure the development of personnel qualifications and policies.
  • Identify and facilitate professional development needs and competency of staff through home visits to supervise and evaluate clinical performance.
  • Maintain compliance with regulatory agency policies and procedures by providing staff guidance in making clinical and case management decisions that are cost-effective and focused on clinical outcomes.
  • Be accountable for team performance in achieving desired clinical and operational performance measures.
  • Utilize clinical software to identify opportunities for education, most appropriate utilization of services, oversee clinical progression of patients and trend team outcomes and performance.
  • Assure that clinical and functional outcomes are achieved at the highest level possible.
  • Resolve patient care problems collaboratively with internal/external customers.
  • Oversee the daily patient assignments for clinical staff based on client needs and staff competency to maintain team productivity standards.
  • Coordinate referrals and ensure timeliness of SOCs and timeliness of adjunct service delivery.
  • Ensure that patient needs are continually assessed.
  • Ensure that an individualized plan of care is developed, implemented, and updated as needed for all patients.
  • Ensure coordination of patient care, including communication with all physicians involved in the plan of care.
  • Determine staffing needs and coordinate hiring to meet service demands for assigned geographic areas.
  • Hire, train, coach, and evaluate staff.
  • Complete personnel evaluations according to agency timelines.
  • Review and analyze team and patient metrics to be consistent with agency initiatives.
  • Participate in preceptor programs.
  • Anticipate customer needs and respond quickly, accurately, and pleasantly.
  • Actively participate in the performance improvement process plan known as H3W.
  • Participate in huddles, IDT, and agency QAPI Program.
  • Perform other duties as assigned.

Benefits

  • Competitive benefits program designed to ensure work/life balance.
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