Clinical Case Manager

Ensures the quality, safe delivery, and cost-effective home care services. Coordinates home care services that reflect VNS Health's philosophy and ensures standards of care are maintained. Works under general direction.

$93,400.00 - $116,800.00 Annual

• Reviews all clinical documentation completed by Registered Nurse Field Supervisors (RFNS) after submission for comprehensiveness, correct format, and legibility and to ensure that standards of care are maintained
• Maintains relationships with personnel of other providers to coordinate patient services, develop joint education programs/goals for their members, and ensure contractual obligations regarding the clinical management of patients.
• Develops and maintains all clinical policies and procedures in conjunction with team members and ensures compliance with all applicable accreditation and regulatory standards.
• Participates in developing and maintaining all written clinical evaluations used for screening, orientation of RNFS, and field performance.
• Participates in the planning and development of business strategies that focus on nursing service opportunities.
• Participates in the development of marketing strategies in addition to direct participation in marketing activities to increase business opportunities.
• Partakes in on-call coverage based on department needs.
• Counsels and advises persons making inquiries about service concerning the necessary level of care and educating members and caregivers on appropriate referral pathways
• Acts as a clinical resource for staff throughout the organization.
• Maintains the highest quality of care to all patients within the assigned area through the support of schedulers and RNFS to timely complete field visits to provide supervision, assessment, training, support, and crisis management.
• Prevents patient incidents by anticipating potential service/care-related issues as communicated to the Clinical Case Manager (CCM) by supervisors, HHAs, RNFS, patients and informal caregivers.
• Participates in investigating all incidents/complaints within the assigned area. Implements disciplinary measures in collaboration with other supervisory and management staff.
• Supports department leadership in the education of new staff. Oversees the ongoing performance of the RNFS during their first three months of transition into a new role and then yearly by conducting field supervision of direct reports.
• Monitors email communication to determine if any changes in the patients clinical condition warrants escalation to the plan or changes in the aide plan of care.
• Evaluates the efficiency of care/service and initiates case management conferences with all healthcare team members as appropriate.
• Ensures all services provided follow accepted nursing practice, regulatory requirements, and accrediting body standards.
• Participates in Quality Assurance and Improvement activities, as assigned.
• Participates in special projects and performs other duties as assigned.

Licenses and Certifications:

• License and current registration to practice as a Registered Professional Nurse, in New York State required
• CPR Certification required

Education:

• Bachelor's Degree in Nursing from an approved program required
• Master's Degree in Nursing preferred

Work Experience:

• Minimum two years clinical experience required
• Minimum of two years managerial experience in a LHCSA or CHAA preferred
• Proficiency in Microsoft Office applications required
• Excellent problem-solving and organizational, interpersonal, and verbal and written communication skills required