Patient Care Manager - RN - Home Health
Company: SunCrest Home Health - Kingsport TN
Posted on: April 30, 2020
The Home Health RN Patient Care Manager is responsible for the
overall supervision and coordination of clinical services.
Coordinates and supervises an interdisciplinary team of staff to
assure the continuity of high quality care to home health patients
assigned to the team's area in accordance with physician prescribed
plan of care, and all applicable state and federal laws and
SunCrest Home Health, a part of LHC Group, is the preferred
post-acute care partner for hospitals, physicians and families
nationwide. From home health and hospice care to long-term acute
care and community-based services, we deliver high-quality,
cost-effective care that empowers patients to manage their health
at home. Hospitals and health systems around the country have
partnered with LHC Group to deliver patient-centered care in the
home. More hospitals, physicians and families choose LHC Group,
because we are united by a single, shared purpose: It's all about
- Receives referrals and ensures appropriate clinician and/or
therapist(s) assignments for timely patient evaluation by signing
off after authorization and plotting start of care (SOC)
- Coordinates determination of patient home health benefits,
medical necessity, and ongoing insurance approvals.
- Ensures patient needs are continually assessed and care
rendered is individualized to patient needs, appropriate and
reasonable, meets home health eligibility criteria, and is in
accordance to physician orders.
- Oversees and assures development, implementation, and updates
to the individualized patient plan of care, as appropriate.
- Manages and documents phone calls from physicians, clinicians,
patients, referral sources, and communicates patient updates/new
orders to clinicians. Uses coordination notes to document, as
needed and appropriate.
- Reviews assessments and plans of care daily, per assigned
workflow, and consults clinicians with recommendations, as
- Coordinates all aspects of care with all disciplines,
physicians, durable medical equipment providers, caregivers/family
members, transferring facilities, and any other applicable
- Follows-up on lab and other clinical diagnostic test, physician
contact, and significant changes in the patient condition to ensure
adequate physician notification, follow-up, and needed plan of care
modifications and communicates such to clinicians.
- Schedules, prepares for, facilitates, and documents case
conference/SOC reports and facilitates effective exchange of
information across disciplines especially with adverse findings,
changes in patient condition, daily and urgent updates, as
- Assists clinicians in coordinating the transfer and discharge
of patients from agency services as indicated by the
- Receives report from field clinicians prior to scheduled days
off on patient status and ongoing needs.
- Processes new orders and updates the visit frequency, as
appropriate, when the oncall RN takes supplemental verbal orders
which alter frequency going forward.
- Writes and processes orders when taking verbal orders directly
from the physician and communicates such to field clinicians.
- Assures payer change documentation is completed properly and
timely, as required.
- Reviews clinician visit notes weekly to ensure timely,
complete, appropriate, and accurate submission of all documentation
by field staff. Takes necessary action to correct adverse findings
and communicates trending to clinical director.
- Reviews, evaluates, and supervises service delivery to ensure
appropriateness of care and utilization of services, equipment, and
supplies through activities such as random patient visits, medical
record reviews and case conferences.
- Enters infections and incidents/occurrences into the online
Risk Management Incident Reporting System, as specified by
- Assists in the orientation of new agency personnel.
- Provides direction and leadership to clinical team members in
collaboration with the clinical director.
- Provides direct patient care, as necessary, in accordance to
scope of practice and physician orders.
- Participates in QAPI program.
- Assures compliance with and ensures timely follow up on daily
clinical and coding edits.
- Directs clinicians in utilizing best practice interventions
when finalizing Plan of Care for all patients.
- Participates in on-call rotation.
- Follows-up with On-Call events daily.
- Receives report from weekend and after-hours clinicians
admitting new patients.
- Completes LHC required learning courses, additional assignments
per Executive Director request, as well as any state specific
required training per state regulation/practice act
- Directs team in adherence to and participates in the Episode
- All other duties as assigned.
- Current RN licensure in state of practice
- Current CPR certification required
- Current Driver's License, vehicle insurance, and access to a
dependable vehicle or public transportatio
Keywords: SunCrest Home Health - Kingsport TN, Kingsport , Patient Care Manager - RN - Home Health, Healthcare , Kingsport, Tennessee
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