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Clinical Manager

Clinical Manager PD 08-09 Page 1




Updated August 2009


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.


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


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.


• 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

human body.

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

environmental conditions.


Report to Clinical Director or Branch Director (in offices without Clinical Directors)

Manage: Nursing Supervisors, Primary Nurses, Field clinicians and aides as applicable

Job Type:



Date available:

Loving Care Agency

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