Do you want to make a difference and help patients heal and age at home? As the Clinical Manager you will be responsible for the day-to-day operations of the Post-Acute Program and provides team leadership and guidance regarding patient centered interventions in acute and post-acute facilities. You will lead a team of Nurse Liaisons in driving the desired clinical outcomes across Hospitals, Inpatient Rehab Facilities and Skilled Nursing Facilities. The Clinical Manager collaborates with case management leadership and physicians to achieve patient centered goals.
Post-Acute Care (PAC) Program is an end-to-end post-acute offering that manages up to 90-day episodes of care, beginning prior to the patient's discharge from the hospital, or for elective surgical cases, outreach begins prior to hospitalization. The program optimizes our home-based network, identifies the likely best site-of-care for the patient, manages length of stay (LOS) if a Skilled Nursing Facility (SNF) is appropriate, and reduces hospital readmissions. Our program also coordinates all of the services required for a patient to transition to their home faster and safer, via our network of home health, durable medical equipment and home infusion providers, all of whom are supported by our CareCentrix care coordination team.
• Responsible for the day to day operations of the Post-Acute Program and provides team leadership across one or multiple geographic markets.
• Works in collaboration with Learning and Development to develop training tools to support introduction of new and existing clinical and non-clinical team members being assigned to facilities.
• Participates in staff development, ensuring department activities are consistent with CareCentrix policies and procedures and contractual agreements.
• Works in collaboration with Learning and Development to develop training tools to assist the Post-Acute Care Program with clinical oversight for both clinical and non-clinical staff.
• Assists Product Portfolio Management team in defining operational process and procedures and implements standardized operation processes to ensure compliance with CareCentrix policies, legal requirements and regulatory mandates.
• In partnership with the Medical Director, functions as the lead clinical resource to Post Acute team. Audits cases and interventions to monitor outcomes, track/trend results and identify opportunities for process improvement.
• Monitors department reports and provides input for team and individual staff improvement opportunities that are in accordance with department and company goals.
• Works with Clinical Management to implement best practices for utilization and authorization management of selected services and contributes to performance and process improvement activities.
• Participates in on-going CareCentrix quality assessment and improvement activities as assigned, and documents information enabling data collection and root cause analysis needed to identify opportunities for improvement.
• Interacts with health plan clinical partners, hospital and skill nursing facility staff, home health agencies and physicians to insure effective education and communication of the tenets of Post-Acute Care Program.
• Encourages/fosters and environment of teamwork, communication, collaboration and readiness for change.
• Current and unrestricted license for the market (state) of practice as a Registered Nurse.
• Licensed in the state PAC services are being rendered.
• Previous management and leadership experience
• Previous Case Management experience preferred. Case Management Certification (CCM) a plus.
• Expertise in Utilization Management and knowledge of URAC/NCQA standards.
• Broad knowledge of managed care regulations, utilization management, case management, clinical coaching, re-engineering processes, contract terms/stipulations, capitation requirements and governmental home health agency regulations strongly preferred.
CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.