Become a part of our caring community and help us put health first
The Clinical Manager, Home Health Nursing leads a team of professional field clinicians. The clinical manager reviews OASIS and regular visit documentation submitted by the clinicians for accuracy, ensuring state and federal guidelines are met. The clinical manager conducts weekly IDT meetings, performs quarterly chart audits, assists with the needs of the branch and other duties as assigned. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration and conducts briefings and area meetings; maintains frequent contact with other managers across the department. The Clinical Manager, Home Health Nursing works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals.
Upon hire through the organization's formal selection process, the Clinical Manager ensures the overall coordination of home health services provided to all clients is delivered in a safe and effective manner. The role is responsible for facilitating the relationship between referral sources, patients, caregivers, and employees. Depending on branch census you may be responsible for other duties as assigned.
Core Responsibilities Clinical:
Track and evaluate clinical quality metrics while ensuring full compliance with regulatory and accreditation standards. This includes oversight of QA/PI activities, care outcomes, documentation accuracy, and timely audits and billing review. Oversee the completion and quality of Starts of Care (SOC), ensuring timely assessments, accurate documentation, regulatory compliance, and effective coordination among clinicians to support safe and efficient admission processes. Ensure accuracy and completeness of patient documentation by reviewing assessments and care plans, identifying compliance risks, and resolving issues that may affect care delivery or coordination. Review, approve, and route physician orders; ensure corrections are addressed and updates to medication profiles and visit schedules are properly maintained. Monitor and respond to changes in patient condition, vital-sign alerts, wound score deviations, and other clinical occurrences; document all follow-up actions and physician communications appropriately.
Core Responsibilities Operations:
Partner with the Branch Director to develop and monitor budget, oversee clinical operations, and evaluate quality and performance metrics. Lead weekly case conferences to guide recertification, discharge decisions, and oversee coordination of care and timely documentation.
Direct all aspects of daily clinical operations, including patient and staff assignments, care coordination, referral management, and oversight of the plan of care. This includes but is not limited to: Hiring, training, coaching, and supporting field clinicians while fostering engagement, retention, and a safe, productive working environment. Oversee laboratory result review, ensure timely identification of abnormalities, and coordinate appropriate clinical responses and physician communication. Monitoring on-call coordination notes and taking timely, appropriate action when issues arise. Addressing and resolving clinical claim deficiencies promptly to ensure accurate and timely billing. Reviewing and approving referrals based on clinical appropriateness and branch capacity to ensure timely initiation of care. Documenting non-admit decisions in HCHB and obtaining Branch Director approval per protocol. Perform patient visits and participate in on-call rotations as needed to support clinical operations.
Use your skills to make an impact
The individual must:
Hold a degree from an accredited institution of higher education.
Maintain an active clinical license in the state of practice and meet all state-specific requirements
Two or more years of experience in health service administration with experience in home health care or related health care program (e.g., hospice, hospital, assisted living) is required.
Demonstrated leadership experience required , either through formal roles (such as team lead, supervisor, or manager) or informal leadership activities (such as project coordination, mentoring, or influencing cross-functional teams).
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$77,200 - $106,200 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
?
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources
