Regional Clinical Manager – Home Health

This is a fully remote position, open to applicants in New York.

📋 Description

• Assist with clinical operations across various locations, including the delivery of patient care, management of staff, maintenance of documentation quality, and adherence to regulatory standards.

• Evaluate referrals to assess admission suitability and confirm that Plans of Care align with both patient and agency requirements.

• Provide guidance, support, and education to clinicians regarding goal-setting, care planning, and clinical decision-making processes.

• Be accessible during operating hours to offer clinical support as needed.

• Ensure that clinical documentation, audits, and billing practices comply with Medicare, payer, and company standards.

• Oversee the quality and outcomes of case management practices.

• Engage in hiring, training, performance evaluations, coaching, and corrective actions for clinical staff.

• Facilitate ongoing education for staff informed by documentation reviews, utilization review results, and performance improvement metrics.

• Coordinate communication among physicians, team members, and caregivers to enhance care coordination, discharge planning, and achievement of outcomes.

• Contribute to quality improvement, data tracking, budgeting, marketing efforts, and the development of community relationships.

• Undertake additional responsibilities to support clinical operations and the organization's goals.

⛳️ Requirements

• Graduate from an accredited School of Nursing.

• Bachelor of Science in Nursing (BSN) is mandatory (as per New York State regulations).

• Possession of a current New York State license as a Registered Nurse; candidates from neighboring states may also be considered.

• Current CPR certification/proof is required.

• A valid driver's license, auto insurance, and dependable transportation are necessary.

• Minimum of two years' experience as a Registered Nurse, including at least one year in a management role within a home health setting.

• Experience with OASIS is essential.

• Proven experience in a Certified Home Health Agency is required (as mandated by New York State), or four years of CHHA experience along with six credit hours toward a BSN.

• Familiarity with Homecare Homebase (HCHB) is required.

• Experience in Quality Assurance and Performance Improvement is necessary.

• Knowledge and/or experience with CMS PDGM billing is required.

• Must complete a TB screening if selected.

• Internet service with a minimum of 25 Mbps download and 10 Mbps upload is required for remote work.

• A dedicated workspace free from ongoing interruptions is vital to protect member PHI/HIPAA information.

🏝️ Benefits

• Bonus incentive plan based on both company and individual performance.

• Comprehensive medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance provision.

• Occasional travel to Humana offices for training or meetings.

• Home-based work arrangement.

• Requirements for a dedicated workspace and internet to support remote work.