Overview:
Ensures the quality, safe delivery, and cost-effective delivery of home care services throughout the patient
episode. Coordinates, manages, and oversees the clinical and operational activities of assigned clinical
staff, including Registered Nurse Field Supervisors (RNFS), and supports the development of clinicians from
onboarding through ongoing competency and performance management. Oversees key home-health workflows,
including referral and assessment coordination, plan-of-care changes, orders, scheduling, documentation, clinical
escalation, quality monitoring, and timely completion of services. Serves as a clinical resource to staff and
contributes to the development and maintenance of clinical policies, procedures, evaluation tools, and education.
Uses clinical systems, operational reports, dashboards, and workflow tools to identify trends, manage
performance, promote regulatory compliance, and improve patient, quality, employee, and financial outcomes.
Works under general direction.
Responsibilities:
• Reviews and facilitates clinical orders and related workflows, follows up on needed corrections or outstanding orders, and collaborates with appropriate staff and departments to support timely completion and continuity of care.
• Leads and/or participates in case management conferences to evaluate the effectiveness and efficiency of care, review changes in patient condition, address recertification or discharge needs, and coordinate interventions with members of the interdisciplinary health care team.
• Monitors the timely completion of scheduled, rescheduled, reassigned, incomplete, and unverified visits; partners with schedulers, RNFS, clinicians, and other operational staff to resolve barriers to service delivery and maintain the appropriate plan of care.
• Monitors after-hours and other clinical coordination communications to identify changes in patient condition, service issues, or other risks requiring escalation, physician or health plan notification, or changes to the plan of care.
• Maintains relationships with personnel of other providers, health plans, physicians, and internal partners to coordinate patient services, support joint education and care goals, and ensure contractual and clinical management obligations are met.
• Serves as a clinical resource for staff throughout the organization and provides consultation regarding appropriate level of care, referral pathways, care coordination, clinical escalation, and home care practice.
• Develops and maintains clinical policies, procedures, standards, competency tools, written clinical evaluations, and other practice resources in collaboration with department leadership, Quality, Education, and other stakeholders; ensures alignment with applicable regulatory and accreditation standards.
• Supports a structured clinician development model from onboarding through ongoing practice. Participates in hiring, orientation, training, competency assessment, coaching, and development of newly hired and existing clinical staff, including RNFS and other assigned clinicians.
• Collaborates with Clinical Director to develop and deliver curricula, learning experiences, and field-based development focused on care management, care delivery, care coordination, documentation, technology workflows, and regulatory requirements.
• Coordinates appropriate field experiences, joint or shadow visits, field supervision, debriefs, and case-management discussions to assess critical thinking, clinical practice, care-management skills, and progress toward defined development milestones.
• Manages employee performance in accordance with organizational policies. Establishes expectations, provides ongoing feedback and coaching, recognizes high performance, addresses performance issues, and collaborates with Human Resources, Quality, Education, and leadership on performance improvement plans and disciplinary actions when appropriate.
• Reviews operational technology and clinical data, including electronic medical record workflows, patient-level reports, scheduling and order-tracking reports, quality dashboards, wound or other condition-specific dashboards, billing or claims-held reports, and Electronic Visit Verification workflows, as applicable, to identify trends, outliers, risks, and opportunities for improvement.
• Ensures identified technology, documentation, order, scheduling, billing, and workflow exceptions are investigated, assigned, escalated, and resolved timely; documents follow-up and communicates with responsible staff and stakeholders as appropriate.
• Monitors clinical indicators and patient-level alerts, including changes in condition, vital-sign alerts, wound progress, laboratory results, documentation deviations, and other available clinical information; ensures appropriate clinical follow-up, escalation, provider notification, and documentation.
• Promotes the highest quality of care through proactive quality surveillance, field supervision, documentation review, regulatory monitoring, and performance data. Ensures services follow accepted professional practice, VNS Health policies, payer requirements, regulatory requirements, and accrediting body standards.
• Prevents patient incidents by anticipating potential clinical and service-related risks reported by supervisors, clinicians, home health aides, patients, caregivers, or operational systems; initiates timely interventions and escalates concerns as needed.
• Participates in the investigation and resolution of incidents, complaints, grievances, and quality concerns within the assigned area; identifies contributing factors, implements corrective actions, and monitors sustained improvement in collaboration with appropriate stakeholders.
• Participates in Quality Assurance and Performance Improvement activities, including review of trends, root causes, action plans, education needs, and process improvements designed to improve patient safety, clinical outcomes, compliance, employee performance, and operational effectiveness.
• Participates in the planning and development of business and clinical strategies focused on nursing and home care service opportunities and, as appropriate, supports marketing and relationship-management activities that increase or strengthen business opportunities.
• Provides on-call, daily, and/or weekend management coverage based on department needs and supports continuity of clinical operations during leadership or staff absences.
• Participates in special projects and performs other duties as assigned.
Qualifications:
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
Pay Range:
USD $93,400.00 - USD $116,800.00 /Yr.