Clinical Nurse Manager

Jethro Health System; Lynn (MA); In loco; USD 69.000 - 83.000; Tempo pieno

Vantaggi offerti da questo lavoro

Flexible schedule

Paid time off

Descrizione del lavoro

Jethro Health System Company is seeking a Registered Nurse (RN) to support daily operations and serve as a clinical coordinator/manager for our home health agency. This role requires MA licensure and a strong background in home health, with responsibilities spanning referrals, coordination, and staff training.

The ideal candidate brings at least 2 years in home health or related fields and can navigate Medicare/Medicaid payer processes, intake, discharge planning, and clinical referrals.

Competenze

• Current RN license required.
• RN licensed to practice in Massachusetts.
• Graduate of an accredited RN program.
• Minimum 2 years related experience including home health, med-surg, and community health and/or managed care experience.
• Previous intake, liaison or discharge planning experience preferred.
• Knowledge of home health care standards (preferred).
• Knowledge of medical terminology and treatment modalities of patient diagnoses.
• Knowledge of Medicare, Medicaid and other payers.

Mansioni

• Coordinate referrals from hospitals, physicians, other health facilities, community agencies and families between patient account center and the clinical nursing team.
• Demonstrate advanced knowledge of home health and Hospice eligibility criteria and COP for referral coordination.
• Prepare and maintain on-call schedule and serve as back up for on-call.
• Assist with marketing activities as required.
• Serve as liaison for branch office with corporate on billing, payroll and collections.
• Lead training for new hires and existing staff including Staffing Coordinators and Admin Support Coordinators.
• Track and report Medicaid and Managed Care prior approvals and coordinate with Corporate Billing.
• Oversee intake of private pay and insurance cases and ensure appropriate paperwork.
• Communicate with nursing staff, coordinators and corporate regarding client care and payments.
• Coordinate weekly staff meetings and manage non-compliance reports.
• Participate in contract meetings, team meetings and client case conferences.
• Communicate referral information with physicians, families and others to organize resources for admission.
• Triage clinical calls from families and referral sources.
• Collaborate with clinical staff to ensure patient suitability and pathway optimization.
• Conduct thorough clinical assessment of referrals and coordinate with referral source.
• Arrange for special medical supplies/equipment as needed.
• Share patient referral information with pod staff.
• Coordinate daily capacity with admissions coordinator.
• Obtain MD orders and support Utilization Review and QA activities.
• Maintain records of referrals and admissions.
• Assist with insurance verification and initial authorization processes.
• Support special customer service referral arrangements with hospitals and physician offices.
• Participate in orientation of new staff and liaison duties.
• Contribute to department goal attainment and ICD-9 coding for referrals.

Conoscenze

RN License

Massachusetts license

Home health care knowledge

Formazione

RN program graduate (accredited)

Descrizione del lavoro

Job Description

We are currently looking for a Registered Nurse (RN) who will help us with daily operations and serve as a clinical coordinator/manager for our home health agency.

Qualifications

• Current RN License Required
• RN Licensed to practice in Massachusetts.
• Graduate of a School of Nursing or College with an accredited RN Program.
• Minimum 2 years related experience including home healthcare, medical/surgical, and community health and/or experience with a managed care organization.
• Previous intake, liaison or discharge planning experience is preferred.
• Knowledge of home health care standards and practices (preferred)
• Knowledge of medical terminology and treatment modalities of patient diagnoses required
• Knowledge of Medicare, Medicaid and other insurance payers.

Functions & Responsibilities

• Coordinates referrals from hospitals, physicians, other health facilities, community agencies, and patients and their families between patient account center and the clinical nursing team.
• Demonstrates advanced knowledge of home health and Hospice eligibility criteria and COP for purposes of appropriate referral coordination.
• Prepare and maintain on-call schedule and serve as a back up for on-call
• Assist with marketing activities as required.
• Serve as a liaison for branch office when dealing with corporate on; billing, payroll and collection resolution.
• Primary responsibility for all training (new hires and existing employees). This includes Staffing Coordinators and Administrative Support Coordinators, specific to their job descriptions.
• Responsible for tracking and reporting all prior approvals for Medicaid and Managed Care contracts and to coordinate all activities with Corporate Billing personnel.
• Responsible for intake of all private pay and insurance cases along with all appropriate paperwork.
• Serve as a liaison between nursing staff, coordinators and corporate regarding client care and payment issues.
• Responsible for coordinating weekly staff meetings with all office staff.
• On a weekly basis review non-compliance reports and remove from cases, all field personnel who are out of compliance with regulatory requirements.
• Participate as required in contract meetings, team meetings and client case conferences.
• Communicates with the patient’s physician, family and others to obtain complete referral information and to assist in organizing resources necessary for patient care prior to admission.
• Triages incoming clinical phone calls from patient’s families and referral sources.
• Collaborates with clinical staff and evaluates patient information/clinical documentation to ensure patient is appropriate for home health care and will be services on the perfect pathway to optimize clinical care.
• Performs thorough clinical assessment of the referral and ensure patient is placed on the perfect pathway and coordinates back with referral source any recommendations.
• Makes preliminary arrangements for any special medical supplies/equipment or for other community services that a patient may require upon admission.
• Communicates with appropriate pod staff to share patient referral information.
• Communicates with pod staff regarding daily capacity. Able to coordinate/communicate that with the patient admissions coordinator.
• Documents and obtains MD orders as appropriate.
• Provides support for Utilization Review and Quality Assurance activities as requested.
• Maintains records and reports of referrals and admissions.
• Provides support for the process of obtaining insurance verification and initial authorization for services.
• Communicate with referral sources, families, and physicians to confirm admission.
• Provides for special customer service referral arrangements with hospitals and physician offices and works closely with liaison staff.
• Participates in the orientation of new staff.
• Assists with liaison functions as necessary.
• Actively participates in activities to attain department goals.
• Participates in ICD-9 coding of referrals.
• Assists in referral entry as needed.
• Upholds the compliance objectives, policies, and procedures of the Foundation and Subsidiaries.
• Performs other related duties of a similar nature and complexity as directed.

Job Types

Full-time, Part-time, PRN, Per diem

Pay

$50.00 - $60.00 per hour

Expected hours

24 – 40 per week

Benefits

• Flexible schedule
• Paid time off

Medical Specialty

• Geriatrics
• Home Health
• Medical-Surgical
• Wound Care

Work Location

In person