HSCHC Sr Clinical Manager

JOB SUMMARY:

The Senior Clinical Manager  is a leadership position responsible for supervising and/or directing all clinical services, overseeing the determination of patient eligibility for services and has a service philosophy that accepts as a goal that while home care is preferred to inpatient care, family care is the preferred care unless clinically inappropriate. The Senior Clinical Manager must establish the strategic direction for the clinical function in the office. The Senior Clinical Manager must be willing to work with referral sources to transition patients to the lowest level of appropriate care. The Senior Clinical Manager will have the responsibility of managing client/family relationships. He/she will establish oversight for managing plans of care and services. Provides oversight for managing client and grievances, managing them into the organizational oversight process, will be liaison to the referral sources and coordinate clinical goals for business units with the goals of the organization.

ESSENTIAL HSC HEALTH CARE SYSTEM VALUES

1. Commitment.   Positively promotes the HSC Health Care System in the community, commits to quality and safety in every aspect of work, and assumes responsibility and accountability for carrying out roles and knowing those of our colleagues.

2. Excellence. Puts forth best effort, actively seeks ways to improve individual performance, and collaborates as a team to improve the performance of our organization as a whole.

3. Diversity.  Works towards inclusion, seeks to understand different perspectives, and treat all families, colleagues, and business associates with dignity and respect.

4. Service. Keeps our patients, members, and families as the focus of our work by providing reliable, responsive and empathic care/services.

5. Respect. Listens carefully to others in daily interactions, deals directly and respectfully with a person with whom we have a conflict, and honors the contributions of all staff.

6. Honesty. Tells the truth, engages fully in open communication, does not participate in spreading rumors or gossip, and discourages rumors and gossip when they are presented.

7. Fairness. Keeps agreements, does not passively condone inappropriate behavior or provide biased advantages to certain individuals.

ESSENTIAL JOB-SPECIFIC FUNCTIONS

1. Establishes and manages clinical budget.
2. Manages clinical schedules and on call coverage.
3. Submits mandatory reports timely as stipulated by the Chief Operating Officer.
4. Working with care managers, patients, and caregivers and referring providers all of whom may define this differently.
5. Proper chart documentation, and referring physician, management of patient family relationships, and recruitment of staff are required duties.
6. Supervises and directs all clinical services.
7. Oversees the determination of patient eligibility for services.
8. Must be willing to work with Managed Care Organizations to transition patients to lowest level to lowest level of appropriate care. This means working with care manages, patients, caregivers and referring providers all of whom may define this differently.
9. Assist in developing care plans in collaboration with the physicians.
10. Manages patient, family relationship for organization.
11. Manages client, family, provider complaints and reports them into the organization oversight process.
12. Acts as a liaison to MCOs,  Hospital and payers
13. Coordinates goals of business unit with the goals of the organization.
14. Effectively supervises all assigned staff in the performance of their daily work and ensures overall timeliness and accuracy of department functions.
15. Meet 100% of clinical budget goals.
16. Effectively budgets and plans for necessary supplies, equipment, resources, and facility space.  Budget requests are reasonable and justified.
17. Effectively participates in Quality/Performance Improvement programs in collaboration with supervisors.
18. Conducts regular meetings with staff. Ensures that staff expectations are consistent with the goals of the company and the system. Builds relationships with staff and works towards creating a service culture.
19. Participates in annual competency goals and clinical employee evaluations.
20. Ensures that performance appraisals for clinical staff are completed accurately, fairly and in support of organizational  philosophy and goals, and are submitted by due date.
21. Approves vacation and leave for clinical staff. 
22. Maintains current knowledge in present area of responsibility (i.e. attends ongoing educational programs).
23.  Maintains skills, licensure, regulatory requirements, and credentials needed to perform assigned duties.
24. Always attends mandatory in services and meetings or arrange with the appropriate supervisor for satisfactory compliance.
25. All clinical skills as demonstrated on the skills Assessment and Demonstration check list(Attachment  A)
26. Perform other duties as required.

QUALIFICATIONS:

Experience:

The Senior Clinical Manager must be a registered nurse with a BSN or master’s preferred, at least 3 years of experience in pediatrics with 5 years’ experience in Home Health care and 5 years supervisory experience. Experience with patient education is a must. Licensure in the District of Columbia, Maryland, and Virginia eligibility is required. Familiarity with Medicaid and Medicare regulations, computer literacy. Must be familiar with the Maryland COMAR regulations for Residential Service Agencies. Familiar with IDC9/10 codes, CPT codes and HCPCS.

Licensure:

Licensed Registered Nurse in the District of Columbia and Maryland.

Education:

BSN required; Masters preferred.

SUPERVISORY RESPONSIBILITIES

The incumbent will be responsible for the general direction of several administrative and clinical staff members.

BLOOD BORNE PATHOGEN EXPOSURE

Category I    

Job usually involves contact with patients or patient specimens.  Exposure to blood, body fluids, non-intact skin or tissue specimens, is possible

PHYSICAL REQUIREMENTS:

External applicants, as well as position incumbents who become disabled, must be able to perform the essential functions, either unaided or with the assistance of a reasonable accommodation to be determined on a case by case basis.