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Home Health Clinical Team Lead / Patient Care Manager

University of Tennessee Home Healthcare Services•Knoxville, TN

About The Position

The Clinical Team Lead / Patient Care Manager (RN) coordinates, supervises, and manages clinical services to support high-quality home health care. The role leads and supports an interdisciplinary team, coordinates patient care, ensures regulatory compliance, manages clinical operations, and promotes positive patient outcomes through effective care planning, communication, and quality improvement. It serves as a clinical resource for field staff, physicians, patients, and caregivers while supporting agency goals and performance standards. The position oversees patient care coordination and individualized plans of care; supervises and develops clinical staff; coordinates communication and transitions among care partners; monitors documentation and regulatory compliance; supports quality assurance and operational processes; and participates in on-call coverage. The role may provide direct patient care as needed and within scope of practice. Travel to patient homes, branch offices, and other work-related locations may comprise more than 50% of work activities.

Requirements

  • Current, unrestricted Registered Nurse (RN) license in the state of practice.
  • Current CPR certification.
  • Current driver's license, reliable transportation, and proof of automobile insurance.
  • Strong leadership, coaching, and team development skills.
  • Excellent clinical assessment and critical thinking abilities.
  • Effective verbal and written communication skills.
  • Exceptional organizational, time-management, and problem-solving skills.
  • Ability to manage multiple priorities in a fast-paced environment.
  • Ability to sit, stand, walk, reach, bend, lift, and drive as required to perform job duties.
  • Ability to lift up to 30 pounds.

Nice To Haves

  • Minimum two years of home health, healthcare leadership, supervisory, or management experience preferred.
  • Knowledge of Medicare Conditions of Participation, home health regulations, and reimbursement guidelines preferred.

Responsibilities

  • Oversee coordination and delivery of patient care to ensure quality, continuity, and compliance with physician orders and regulatory requirements.
  • Receive referrals, review patient information, determine agency appropriateness, and assign clinicians and therapists for timely admissions and evaluations.
  • Develop, implement, and oversee individualized plans of care in collaboration with patients, families, caregivers, physicians, and the interdisciplinary team.
  • Continually assess patient needs and ensure care is individualized, clinically appropriate, and consistent with payer and eligibility requirements.
  • Review diagnoses, medications, assessments, plans of care, and clinical progress to support quality outcomes and appropriate interventions.
  • Guide clinicians on best practices, patient management, disease processes, and plan-of-care development; provide direct patient care as needed within scope of practice.
  • Supervise and support clinical staff and ensure adherence to agency policies, clinical standards, and regulatory requirements.
  • Mentor field clinicians, provide coaching and problem resolution, and assist with recruitment, interviewing, onboarding, orientation, and retention.
  • Participate in staff development, in-service education, and competency activities, and ensure adequate clinical leadership coverage during operating hours.
  • Coordinate care among physicians, clinicians, therapists, durable medical equipment providers, community resources, patients, and families.
  • Manage physician communications, verbal orders, care updates, and treatment modifications; follow up on laboratory results, diagnostic testing, significant patient changes, and physician notifications.
  • Facilitate, lead, and document interdisciplinary case conferences and care coordination meetings; assist with transfers, discharges, and transitions of care.
  • Maintain effective communication with team members about admissions, clinical concerns, and patient care needs.
  • Perform chart audits, clinical record reviews, and documentation monitoring; provide corrective guidance to support timely, accurate, and complete documentation.
  • Participate in QAPI activities and agency quality initiatives; assist with risk management reporting, infection tracking, incidents, and occurrence reporting.
  • Review service utilization, patient outcomes, and resource use to promote effective and efficient care delivery.
  • Ensure timely completion and follow-up of clinical, coding, compliance-related edits, and documentation requirements.
  • Support daily clinical operations and episode management; assist with payer authorization management, insurance approvals, and benefit verification.
  • Participate in the on-call rotation and follow up on after-hours clinical events, admissions, and patient concerns.
  • Participate in community, professional, and public relations activities that support agency growth and reputation.
  • Perform additional duties and special projects as assigned by agency leadership.
  • Directly supervise and support clinical personnel and interdisciplinary team members, providing performance coaching, guidance, and accountability for quality patient care and documentation standards.

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