Humana

About Humana

 

Job Category:

Integrated Care & Care Operations - Care Management

Country:

United States

Postal Code:

33401

Approximate Salary:

Not Specified

Position Type:

Full Time

Clinical Supervisor (Medicare Home Health)- Tampa, Florida

Humana - West Palm Beach, Florida

Posted: 08/31/2018

Description

The Supervisor, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Supervisor, Care Management works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach.

Responsibilities

Role: RN Clinical Supervisor (Medicare Certified Home Health)

Assignment: Humana at Home

Location: Tampa, Florida

Are you a fit?

Humana at Home/ Senior Bridge is seeking a Clinical Supervisor to ensure quality and appropriateness of service to all Humana Members who are assigned to the Certified Home Health Program. The position will be knowledgeable and compliant with all applicable laws and regulations to which we may be subject. By ensuring service and satisfaction standards, the position will result in improved client wellness by achieving quality outcomes. 

Assignment Capsule:The Clinical Supervisor is responsible for ensuring that patient care is coordinated and managed appropriately. The Clinical Supervisor is responsible for ensuring that care and services are delivered appropriately as well as the supervision of clinical personnel.The Clinical Supervisor position includes the following

  • Provide nursing services within the scope of proactive authorized by the license issued by the state of Texas for a registered nurse.
  • Received case referrals. Reviews available patient information related to case, including disciplined required, to determine home care needs. Assigns appropriate clinicians to case.
  • Reviews and evaluates each case by reviewing the services provided by clinicians, conferences, record review, discusses and verified impressions, instructs and guides clinicians to promote more effective performance and delivery of quality home care services, and is available at all times during operating hours to assist clinicians as appropriate.
  • Reviews patient’s clinical diagnosis, medications, procedures and clinical course.
  • Assists clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing plan of care.
  • Ensures that all Medicare services meet the face to face requirements and that a signed and dated face to face document is on file in Medicare recipient’s clinical records
  • Ensures that services are based on an accurate assessment and reflect the results of the assessment
  • Monitors patient services against HHRG scores to ensure appropriate level and frequency of services
  • Ensures that multi discipline assessments are timely and recorded in the system to ensure that physician orders are mailed timely and that OASIS data is transmitted timely
  • Monitors physician orders (plans of treatment and verbal orders) for timely receipt of signed and dated orders
  • Ensures that therapy assessments are timely and accurate
  • Ensures that client adheres to discharge plan and monitors client for key issues to avoid re-hospitalization; adhering to physician follow-up appointments, understanding signs and symptoms of disease exacerbation, medication, compliance and social an economic issues that may impact compliance.
  • Coordinates post home health discharge plans with long term care management as appropriate
  • Provides Manager, Clinical Services with feedback on adequacy of staffing levels to meet Agency’s needs
  • Attends case conference meetings with organization personnel to facilitate coordinate of care
  • Conducts quarterly record reviews and communicates findings and recommendations to Manager, Clinical Services and appropriate organization personnel.
  • Assists in the screening and interviewing process of new organization personnel and makes recommendations for employment of individuals. Assists in the orientation of new organization personnel.
  • Assists Manager, Clinical Services in the planning, implementation and evaluations of in-services and continuing education programs.
  • Assists in the formulation, revision, implementation and evaluation of policies and procedures, as well as strategic goals and objectives.
  • During staffing shortages or unexpected increase inpatient volume, may be asked to function as Registered Nurse and provide direct care with responsibility for all function within the Registered Nurse position description.
  • Participates in on-call duties as defined by the on-call policy
  • Complies with accepted professional standards and principals
  • Performs any other activities as directed by the Manager, Clinical Services

               

Must Haves

  • One year of recent clinical management and/or supervisory experience in home health care or community based long term care services that meets individual state requirements
  • Minimum Associate's Degree in Nursing valid in the state of Florida with no restrictions
  • This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
  • Possession of valid state driver’s license and access to an automobile
  • Solid community and professional reputation
  • Effective communicator
  • Enthusiastic, positive thinking
  • A collaborator with experience in a team-based approach to client care
  • Knowledge of community based long term care services and methods of delivery
  • Knowledge of Medicaid and Medicare home care services parameters
  • Knowledge of regulations and understanding of meeting state and federal requirements for respective services
  • Knowledge of quality assurance and quality improvement models, data collection methods, analysis and reports
  • Evidence of leadership skills to ensure high quality, appropriate service delivery
  • Excellent verbal and written communication skills, comfort with speaking publicly
  • Sensitivity to cultural diversity and to making accommodation available to provide services to a diverse population
  • Ability to work well under pressure; critical thinker
  • Strong customer service skills

Scheduled Weekly Hours

40

Apply Now