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Clinical Field Staff Supervisor (RN Case Manager)

Mays Home Health Texarkana, TX

  • Expired: over a month ago. Applications are no longer accepted.
Job Description: REPORTS TO: DIRECTOR OF NURSES (DON) QUALIFICATIONS EDUCATION/TRAINING/EXPERIENCE 1. Must be currently licensed as an RN through the Board of Nursing in the state of practice. 2. Must have at least an Associate’s Degree in Nursing. 3. Prefer one year clinical experience in the health care industry, and one year experience in home health. Must understand the issues related to the delivery of home health services and be able to problem solve effectively and possess knowledge of the Medicare guidelines governing home health agencies or have experience/abilities that indicate with training they would excel. 4. Prefer supervisory experience CHARACTERISTICS 1. Must be organized, detail oriented and possess effective communication skills, both orally and in writing. The ability to communicate with a diversity of individuals is required. 2. Must have good clinical judgment and observation skills 3. Must have a positive attitude, is self-directed and has the ability to work with little supervision 4. Must be willing to comply with accepted professional standards and principles. 5. Must be flexible and cooperative in fulfilling role obligation. 6. Must have satisfactory references from previous (or current) employers, nursing school, and/or professional peers. MINIMUM REQUIREMENTS 1. Must possess a valid state driver’s license and adhere to all state laws while driving 2. Must possess automobile liability insurance 3. Must have dependable transportation kept in good working condition 4. Must be able to drive an automobile in various types of weather/road conditions 5. Must possess intermediate computer skills SUMMARY OF JOB RESPONSIBILITIES The Clinical Field Staff Supervisor (CS) is responsible for the overall coordination of home health services provided to Medicare and non-Medicare patients. The CS is responsible for the provision of quality services according to acceptable clinical and agency standards of practice and continually monitors the services provided. The CS is a resource person that gains extensive knowledge of the regulatory and practice guidelines governing home health agencies-who ensures compliance with agency policies, State and Federal laws and regulations. The CS is the liaison between the community, referral sources, physicians, patients, caregivers, agency staff, and contract disciplines. RESPONSIBILITIES AND DUTIES 1. Provides a positive work environment by consistently modeling in a positive way, the agency philosophy, mission, values, and standards of care, and providing a professional role model for other staff. Ensures field staff are educated on process and regulatory changes. 2. Adheres to HIPAA regulations and follows agency protocol maintaining confidentiality and does not improperly disclose of patient information. 3. Complies with all agency policies and procedures. 4. Is diligent in activities that ensure advanced proficiency in Homecare Homebase (HCHB) Electronic Health Record (EHR). Actively seeks out training and continuing education in agency processes including participation in offered classroom training and e-learning courses. Communicates as appropriate with staff, physicians, referral sources, community, patients, potential patients, caregivers, and others involved in care. 5. Receives referrals with enthusiasm from physicians and staff and may participate in entering referral into the Electronic Health Record (EHR). Clearly identifying the referral source. 6. Provides supportive activities to obtain Delayed Physician Certification for Home Health Services (also referred to as Face-to-Face (F2F)) if the Certification was not received upon referral. Activities may include but, are not limited to assisting with completing the Delayed F2F form for DON approval, coordinating with physician to set up appointment, coordinating with patient/caregiver for reminder and to ensure they have transportation to the appointment, and tracking receipt of F2F. 7. Ensure patients on services meet criteria established by their payer source such as medical necessity and homebound status and ensure documentation clearly indicates the criteria are met. 8. Ensure assessing clinicians and ancillary staff provides exceptional patient care by utilizing all elements of the nursing process and/or agency standards of care. Ensure the level of care and services provided coincide with the patients’ level of acuity and meet their needs. 9. Ensure assessing clinicians and ancillary staff is providing care within their scope of practice and submits quality documentation authenticating appropriate assessment and intervention provided to the patient. 10. Completes Client Related Task of Review Evaluation Documentation which presents in workflow once the assessing clinician has completed the evaluation to ensure quality care, quality documentation, criteria met for patient to qualify for services and plan of care established to meet the needs of the patient. A. Review all required items such as Unlisted Item Report (to coordinate adding unlisted allergies, meds, and/or supplies), Visit Note (for information regarding patient status), Medication Profile (to review contraindications), Calendar (to ensure proper disciplines, frequencies, and buddy codes), Problem Statements/Care Plans (to ensure proper 485/goals and pathways), OASIS Report (for HIPPS,HHRG and OASIS info), Coordination Notes (for idea of patient status), Aide Care Plan (for aide services), Supply Requisition, Initial Order (for review), Authorization Information Report (for non-Medicare patients), Case Mix Details and Insight Report (for insight into clinical, functional, and service areas), Medicare Utilization Summary (Episode Analysis Tool to manage financial viability, revenues, costs, and visit details), Therapy Report (to determine likelihood of need for therapy), HHCAHPS Survey Data (Home health survey data), etc. B. Review non-required items as indicated such as OASIS, Vital Sign Parameters (to ensure patient specific parameters are set), Previous Orders, Pharmacy Info, 485 order, and Claim Codes (to ensure accurate billing codes). C. Coordinate with assessing clinician to assist in establishing short and long term therapeutic goals and setting priorities. Receive authorization from the assessing clinician to make necessary edits to reflect an accurate assessment and to provide patient with appropriate pathways, interventions and services. Coordinate with assessing clinician and physician to establish a plan of care and initiate services specific to the patient’s needs. 11. Reviews various types of coordination notes which communicate pertinent patient information or data related to patient care and provision of services. Provide additional coordination with physician, disciplines, and patient/caregiver as necessary. 12. Reviews coordination notes that are automatically generated when medication issues are recognized and communicates drug interactions, duplications, and contraindications to the physician within establish Medicare timelines. Implements instruction given by physician regarding the medication issue(s), communicates physician’s response to the patient/caregiver, and follows-up to ensure compliance. Reviews/Edits/Approves 485 ensuring diagnoses/coding are accurate and calendar is complete with disciplines/frequency/buddy codes, collaborating with the assessing RN to receive authorization to edit as necessary. Holding 485 so that workflow will go to Patient Services Coordinator (PSC) to schedule and so that additional clinical review can be performed. 13. Reviews additional assessment comparison tools such as SHP (Strategic Health Care Programs) to measure outcomes, to ensure OASIS/coding accuracy, and to ensure services provided to patients is concurrent with National and State Standards. 14. Reviews/Edits/Approves held 485 for thorough review of all data fields making spelling and grammar corrections, ensuring orders concur with assessment and OASIS documentation, and goals/interventions are specific to patient needs. Once complete work flow will then go to the Coding Specialist for review. 15. Reviews list of recommendations made by the Coding Specialist and collaborates with assessing clinician to review/implement/reject recommendations related to coding, OASIS accuracy, and documentation. Obtains authorization from the assessing clinician prior to editing and completes appropriate coordination note to indicate to the Coding Specialist recommendations that were accepted or declined. 16. Collaborates with other disciplines such as therapy when patient has medical necessity and meets criteria for such services. Integrates their assessment into the EHR following the workflow of Reviewing Add-on documentation, Review/Edit/Approve Add-on Order, and any other patient related task including updating the calendar to include the visits. Continues to monitor to ensure these disciplines are following the established plan of care, is compliant with re-assessments within the timelines established by Medicare, providing excellent patient care, providing quality documentation, and meeting the needs of the patient. Reviews discipline only discharges to ensure frequency and goals have been met. 17. Maintains communication regarding patient care with the physician and other disciplines involved in the care. Receive calls from field staff and physicians regarding patient care issues/orders. Enters orders as appropriate and updates the medication profile and schedule. Enters information regarding all communication into the Coordination Notes section of the EHR. Updates the plan of care as necessary and notifies physician and staff as appropriate to ensure proper coordination of care. 18. Reviews/Edits/Approves new orders as they appear on the Action Screen. Approves or declines as appropriate. Follows-up with licensed clinician to receive authorization as necessary should orders need to be edited. Updates the client’s m

Mays Home Health

Address

Texarkana, TX
75501 USA

Industry

Healthcare

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