Registered Nurse Clinical Case Manager

Company Description

MGA Homecare specializes in providing private duty nursing, personal care services, and therapy to the medically complex population. Compassion and integrity are at the heart of everything we do! We deliver high-quality care in the home and community-based setting; the setting which is the lowest cost to the payers. We aim to be the employer of choice and the partner of choice to referral sources, state government agencies, and health plans. We currently provide care in Arizona, Colorado, Texas, and North Carolina with a plan to grow into new states and markets.

We are growing and have an immediate opening for an RN Clinical Case Manager to join our amazing team!

This role reports directly to Clinical Supervisor and is responsible for care coordination of clinical staff and patient/family clientele. Responsible for admissions and recertification assessments, including supporting documentation, as assigned. This position ensures compliance with MGA policies, State policies and procedures, and policies of accrediting agencies, as well as responsible for maintaining compliance with all reimbursement guidelines and maintaining patient confidentiality/HIPPA guidelines. Furthermore, individual will participate in program development, implementation, as well as collaborating with Client Service Managers to acquire/develop new relationships with clientele.

Job Description

Duties and Responsibilities

• Ensures supervision of all home care personnel, as assigned:
• Enforces/ demonstrates compliance with State/ Federal regulations.
• Ensures effective communication to coordinate the implementation of each patient’s Plan of Care.
• Instruct, train, and re-educate on clinical skills/procedures when necessary.
• Responsible for direct supervision of field LVNs/LPNs/RNs per State guidelines.
• Provides support, guidance, and education to patients/patient families and or caregivers to maintain optimal physical and emotional wellbeing.
• Communicates all occurrences and other pertinent information to the Clinical Supervisor/Director of Clinical Services.
• Ensures any observed or suspected child/adult abuse, neglect, or exploitation is reported to proper authorities as mandated as a health professional.
• Collaborates with Clinical Supervisor and Director of Clinical Services to resolve client/clinical concerns in timely manner.

Office Responsibilities to Ensure and/or Facilitate the following:

• Develops and implements the treatment plan for each patient under the direction of physician.
• Completes all clinical documentation in timely manner, including admissions, recertification’s, resumptions of care, accurately and ensures that documentation meets all requirements per agency policies and State regulations.
• Reviews clinical documentation to ensure it is complete and reflects skilled services to meet payer source requirements for reimbursement.
• Interviews and evaluates potential clinical field staff to ensure competency in order to promote appropriate/safe patient care.
• Complies and participates in the continuing quality improvement by appropriately reporting of incidents, injuries, infection and all components of the risk management program.
• Participates in agency sponsored continuing education in-services and conferences to maintain own clinical competency.
• Supports and executes the mission, ethics, and goals of the company effectively.Represents themselves in a positive and professional manner in the company and community.Adheres to dress code with a clean and neat professional appearance.Reports on time and as scheduled in order to complete work within designated time.Adheres to all company policies and procedures outlined in Employee Handbook, Employee Agreement, or communicated from executive team.

Clinical Manager Oversight

• Making patient and personnel assignments;
• Coordinating patient care;
• Coordinating referrals;
• Assuring that patient needs are continually assessed; and
• Assuring the development, implementation, and updates of the individualized plan of care.

Qualifications

• Current state license as a Registered Nurse, BSN preferred.
• Minimum of two years of nursing experience in a Home Health or Acute setting preferred.
• Demonstrate leadership capabilities with strong supervisory and interpersonal skills.
• Detail oriented, flexible, good organizational and time management skills.
• Knowledge of cost management for clinical services.
• Current CPR card and Current health certificate as applicable.
• Current state driver’s license and automobile insurance.