Job Description

• Be responsible for daily completion of the following tasks: Referral Processing, Ongoing Orders, Workflow,
  Escalation/Complaint Calls, Updating Clinical Information, Reporting, Verbal Orders, Field Visits as required.
• Perform clinical preparation of key office functions: stand up/ stand down & case conference that ensure
  compliance KPIs:
  1. LUPAS – report and manage patient episodes that are at risk for LUPA status – including: recognition
  of risk, understanding missed visit reasons, coordinating with clinicians/patients/families/schedulers
  as needed, ensuring timely resumption of care as needed, etc.
  2. Paraprofessional Utilization – report and manage case management model – including: correct visit
  types selected; continuity of clinical care team, capacity management, etc.
  3. % of Clinicians between 26-32 points – report and manage clinician productivity – including: tenured
  productivity to target (identifying trends and working with PCM to mitigate issues), recent hire
  productivity (understanding current onboarding status to manage as needed), capacity planning
  4. Workflow completion – task-based duties that bog down many current Patient Care Managers
• Perform other clinical coordination duties as assigned.
• Ensure services are in compliance with professional standards, state and federal regulatory requirements.
• Comply with applicable legal requirements, standards, policies and procedures including, but not limited to
  the Compliance Program: Code of Conduct, HIPAA and Documentation Standards.
• Maintain a commitment to the values and mission of the company
• Complete additional responsibilities as assigned by one’s supervisor or other manager related to the position/department.

• RN or LVN/LPN with current licensure to practice nursing in the practicing state
• Possess and maintain CPR certification
• Previous experience in home care setting preferred
• Must be a licensed driver with an automobile that is insured and in accordance with state and/or organization requirements and is in good working order
• Prior use of Electronic Medical Records (EMR) preferred
• Knowledge of accepted professional standards and practice, Medicare Conditions of Participation, and federal, state, and local regulatory requirements
• Demonstrates excellent observation, nursing judgment, and communication skills