Clinical Team Manager, Home Health Full Time

The clinical team manager is responsible for managing, supervising, coordinating, evaluating, and developing client care teams to ensure quality care delivery and appropriate case management within Brooks Rehabilitation’s scope of services and policies; state, federal, and local laws; and Nurse Practice Act. Responsible for the oversight of personnel and all patient care services provided.  The CTM may at times provide direct patient care to patients by utilizing the nursing process and accepted standards of practice. Participates in and is an active member of the patient’s interdisciplinary treatment team. The CTM also directly supervises  the patient care team and assists to implement the patient's plan of care.

Job Responsibilities: 

• Manages and directs a team of Nurse and Therapist Case Managers ensuring safe, effective, and appropriate home care services.
• Is available at all times during regular business hours and as needed to provide support and assure quality care delivery to home care clients.
• Coordinates and receives referrals, determines services required, and Brooks Rehabilitation’s  ability to meet needs. (484.105(c)(3)  Facilitates making patient and personnel assignments. (484.105(c)(1)
• Coordinates patient care. (484.105(c)(2)
• Meets with Case Managers/clinical staff on a regular basis to provide guidance and information related to specific issues.
• Assures the development, implementation, and updates of the individualized plan of care. (484.105(c)(5).  Provides direction to teams to assure that client needs are met and services are provided according to the plan and current clinical practice guidelines and professional standards. 
• Assists clinical staff in establishing priorities, setting goals, and evaluating progress toward goals.
• Leads case conferences and other clinical meetings to facilitate coordination of care and assures patient needs are continually assessed. (484.105(c)(4)
• Collaborates with Brooks Rehabilitation Leadership in identifying operating budget needs and priorities for the department
• Reviews weekly team members’ productivity information
• Coordinates 24-hour Agency coverage by Registered Nurses. Evaluates quality of on-call services
• Provides on-call coverage as needed
• Provide direct patient care in the field in accordance with the RN job specifications. 
• Develops working relationships with other health care professionals in the community.
• Provides support and direction to Agency staff, other health care professionals, clients, and families related to appropriate and available health care resources
• Educates Agency staff on clinical services, policies, and procedures as needed
• Facilitates problem-solving sessions to enable Case Managers and other staff to resolve client and/or reimbursement source issues
• Stays current on available community resources, health care costs, and industry trends through self-education and access to outside educational opportunities
• Ensures accuracy, completeness, and timeliness of clinical documentation in accordance with Agency policies and procedures, regulatory requirements, and industry standards
• Monitors open and closed charts regularly, and participates in the quarterly clinical record reviews and QAPI activities.
• Reviews Agency policies and procedures and recommends changes or revisions as needed
• Provides educational programs and information regarding appropriate documentation practices
• Provides leadership to team and support staff in identifying Agency/client needs and opportunities for quality improvement
• Assists with marketing, public relations, and discharge planning by participating in departmental meetings
• Assists quality improvement teams with data collection for the Quality Assessment and Performance Improvement Plan established by Brooks Rehabilitation
• Reviews OASIS data collection to assure accuracy and consistency with requirements. Communicates with clinicians and provides training as indicated to achieve compliance with collection and reporting timelines
• Oversight of Teams clinical outcomes and process measures. Actively implements measures to improve outcomes including those identified in the QAPI program.
• Identifies and implements changes in clinical and/or operational practice based on the findings of the QAPI Program
• Interprets and enforces human resource policies and procedures in a fair and consistent manner
• Assists in the screening and interviewing of new Agency personnel and makes recommendations to Director of Nursing. Assists in the orientation of new personnel.
• Conducts timely performance evaluations in accordance with Agency policy
• Provides on-site supervision per Agency policy and as needed to determine st