Clinical Manager PD 08-09 Page 1
Updated August 2009
I. POSITION SUMMARY
The Clinical Manager oversees the development/implementation of care plans within
scope of practice, provides oversight to the care provided, manages and supervises field
clinical and supervisory staff assigned to their patients and operates under the general
supervision of the Clinical Director or Branch Director. The Clinical Manager ensures
that proper care is provided to patients, and that services are provided according to
acceptable standards of practice. The clinical manager, either directly or in a supervisory
capacity, plans, implements, coordinates, monitors and evaluates clinical services and
options necessary to meet an individual patient’s needs within the scope of services
offered by the agency. In addition, the Clinical Manager may consult with third party
payer representatives regarding patient financial responsibility; obtain reauthorizations
for ongoing or additional services. Implements standards, maintains the integrity of
operational policies, and participates in performance improvement activities as
appropriate. Works under general direction.
II. POSITION REQUIREMENTS:
1. Bachelor’s degree or the equivalent in nursing preferred
2. Minimum 3 years experience in area of practice; 1 year in a supervisory/management
3. Specialized clinical certification in area of practice preferred (e.g., geriatric/pediatric
clinical specialty, etc)
4. RN licensure in good standing in the state(s) of practice
5. Ability to prioritize workload in an appropriate manner
6. Excellent communication and analytical skills
7. Able to work in, and create a team environment
8. Effective time management and scheduling skills with a certain amount of flexibility
9. Knowledge of Federal/State/Medicaid guidelines
10. Strong clinical judgment and critical thinking skills to make effective decisions
III. DUTIES AND RESPONSIBILITIES:
1. Coordinate admission with referral sources/facility discharge planners, families and
field staff as applicable to ensure a smooth transition for all new admissions.
2. Conduct/delegate the assessment and reassessment of patients, including
establishing/updating care plans and personal care plans (Home Care Aide plans),
determining patient needs, in adherence with Company policy, physician’s orders,
Clinical Manager PD 08-09 Page 2
and payer requirements. Manages/oversees the assignment of caregivers. Ensures
contact with community resources and other service programs to make
recommendations as needed for additional services (e.g., Adult/child protective
services, Meals on Wheels, MSW Consultation, etc.)
3. Coordinate communication among team members, physicians, primary nurses, and
field staff to ensure that appropriate care is provided. Ensures compliance with third
party requirements through review of documentation and care coordination activities.
4. Understand patient/family dynamics and ensures all staff are aware of special
circumstances, maintains open communication with the patient/family; and handles
complaints/issues to resolve problems
5. Ensure care is provided and documented in accordance with clinical/service delivery
standards, company policy, and state/federal/payer requirements.
6. Consults with payer representatives as needed regarding services provided,
authorization and reimbursement procedures.
7. Participate in recruitment/interviewing/selection process and orientates field staff,
evaluates their performance relative to job goals/requirements, provides coaching and
counseling for staff as needs are identified. Ensures required education is provided.
Provide Orientation, Preceptorship and supervision of all field staff as needed.
8. Complete and/or oversee Post-Orientation and annual Field Staff performance
9. Participate in performance improvement activities, maintains ongoing clinical
knowledge through internal/external training programs.
10. Maintain relationships with referral/community sources, participates in professional
organizations and conducts care related programs.
11. Ensure all documentation is submitted, reviewed (per requirements), completed and
filed in timely manner.
12. Perform QA/Chart Reviews, communicate deficiencies to staff and provide
education, to improve performance. Develop and implement actions plans.
13. Ensure payer requirements are understood, required documentation is submitted and
authorizations are secured (insurance, State waivers, etc).
14. Review clinical/aide documentation per policy and as needed to ensure standards are
met. Review of documentation to ensure accuracy, quality and timeliness and
communicate to all staff regarding issues, provide education and/or counseling to
improve performance.15. Receive/review and approve all new referrals (whether locally or centrally
processed). Oversee, coordinate patient admissions, assessments, reassessments,
ongoing service delivery, and provide clinical oversight and management for all
aspects of care provided to their patients. Maintain physicians’ orders as required,
ensure orders are secured, and provide routine case supervision.
16. Maintain appropriate in-home documents/records, ensure schedules are accurate,
appropriate and communicated with patients/families, and all staff.
17. Assist scheduling staff to manage expenses by planning visits/shifts,
determining/managing geography and eliminating inefficiencies in the scheduling
processes (e.g., reducing duplication of visits, supervisory visits, etc.).
Clinical Manager PD 08-09 Page 3
18. Resolve staffing issues and after hours/weekend call schedules, provides supervision,
education, and counseling as required.
19. Conduct or delegate on-site visits to provide supervision, evaluate care/services
provided, communicate changes, and provide patient-specific information for all staff.
20. Contact the physician as needed to clarify orders and report changes with the patient’s
21. Recommend required equipment, supplies, etc are available as needed, and that staff
understands safety requirements, cleaning, calibration, etc.
22. Ensure patient safety issues are identified, disaster classification codes are assigned,
and evacuation plans are established and routinely revised as needed.
23. Work closely with scheduling staff to ensure appropriately qualified staff is assigned
to meet patient needs.
24. Meet regularly with the Branch Director, field staff, and internal and external
providers to discuss weekly plans, progress and issues.
25. Advocate for and act on behalf of patients to ensure required authorizations are
obtained and patients are progressing as anticipated, or to change the plan as needed.
26. Participation on Committees as needed (Clinical Record Review, Professional
Advisory, Performance Improvement, etc).
27. Ensure tracking mechanisms are in place to ensure all required documents are
received and/or tracked. Resolve issues as identified.
28. Ability to travel as required for business purposes.
29. Maintain confidentiality regarding all aspects of patients and/or employee
information in compliance with HIPPA rules. Maintain compliance with applicable
state and federal regulations, company policies/procedures and accreditation
30. Provide on-call support and availability for after hour clinical needs.
31. Other duties as assigned.
IV. OTHER NECESSARY SKILLS• Physical demand and requirements: stooping, crouching, reaching, standing, walking,
pushing, pulling, lifting, grasping, feeling, talking, hearing, bending, seeing, repetitive
motions, climbing and digital dexterity and sensitivity.
• Physical requirements:• For office work – exerting up to 10 lbs of force occasionally and or a
negligible amount of force frequently or constantly to lift, carry, push, pull or
otherwise move objects. Sedentary work involves sitting most of time. Jobs
are sedentary if walking and standing are required only occasionally and all
other sedentary criteria are met.• For patient visits; Exerts up to 50 lbs. of force occasionally, and /or up to 20
pounds of force frequently and/or a negligible amount of force frequently or
constantly to lift, carry, push, pull or otherwise move objects, including the
Clinical Manager PD 08-09 Page 4• Visual Acuity: Must have visual ability to prepare and analyze data and
figures, transcribe, read extensively, operate machines, tools and devices
utilized, operate motor vehicle, and perform nursing functions/techniques
involved in the job responsibilities.• Work Conditions: The worker is subject to both inside and outside
V. SUPERVISION & MANAGEMENT RESPONSIBILITY:
Report to Clinical Director or Branch Director (in offices without Clinical Directors)
Manage: Nursing Supervisors, Primary Nurses, Field clinicians and aides as applicable