Team Manager Home Care

The Team Manager leads the Patient Care Team to supervise, evaluate, and coordinate the interdisciplinary team; ensure continuity of care from admission to discharge or bereavement transfer; advocate for patients and coordinate with social services and community health care providers involved in the team s patients; maintain patient records from intake through discharge or bereavement.

• Directs all patient care services for the team, including volunteer and bereavement, ensuring services are integrated components of the interdisciplinary plan of care.
• Reviews information on pending admissions, new admissions (assessments and history), and alive discharges to verify eligibility and appropriateness criteria are met.
• Collaborates with the team physician and attending physician on palliative care measures for pain and symptom management.
• Ensures complete and accurate data and documentation to support recertification decisions, and that decisions are made in a timely manner.
• Reviews imminent alive discharges to assure effective discharge planning.
• Monitors the type and level of team services (staffing, medications, home medical equipment, supplies, level of care changes) to ensure they are appropriate and responsive to patient/family needs and expectations.
• Manages the team schedule and ensures 24/7 coordination of services for all patients on the team.
• Facilitates team meetings, ensuring interdisciplinary input into updates and revisions of the plan of care as needs evolve.
• Participates in on-call rotation.

• Interviews, selects, trains, supervises, evaluates, and dismisses team staff in conjunction with the Patient Care Administrator.
• Assures staff competence and performance through field visits, documentation reviews, and in-service training on VITAS values, hospice principles, and team growth needs.
• Acts as a resource and mentor for staff on clinical issues, documentation, inter- and intra-team problem solving, and customer service behavior.
• Oversees staff and volunteer schedules and workload distribution to meet productivity expectations.
• Reviews and approves payroll, ensuring accurate time, mileage, and expenses are documented.

• Monitors clinical records and team activities to ensure accuracy, completeness, and compliance with VITAS policy and regulatory bodies.
• Develops and implements performance improvement activities in response to service issues and participates in quality and service improvement programs.
• Ensures completion of proactive patient/family satisfaction surveys and implements quality improvement measures and standards.
• Assists with surveys and requests from regulatory bodies as directed by local programs.
• Performs substantive chart reviews to ensure evidence of quality care.
• Participates in Outcomes Management and annual program review.
• Performs utilization review of continuous care and inpatient levels of care for all patients on the team.

• Addresses problems/grievances/service failures experienced by patients, families, physicians, MCOs, or other stakeholders with team members, vendors, and other VITAS departments, resolving them promptly.
• Analyzes customer service issues to identify causes and works with the team to improve performance.
• Communicates with patients/families and attending physicians when patient considerations arise to seek satisfactory solutions and reduce unnecessary revocation.
• Regularly visits LTC and Contract Bed facilities to ensure care plan integration and customer satisfaction, and discuss criteria for determining appropriateness.
• Participates in in services to customers with team members and program staff.
• Engages in professional, voluntary, or community service organizations.

• Verifies/approves admitting IPOC diagnosis, treatments, staffing, and supplies.
• Monitors resource utilization to ensure cost-effective delivery of services.
• Controls productivity, labor, and related patient care costs relative to the budget.
• Approves all bills/invoices related to patient care services.

• Attends in-services, educational seminars, and workshops.
• Develops and pursues professional growth goals and objectives.
• Mentors newly hired Team Managers.

• Reliable transportation with appropriate license and insurance coverage for driver and passengers.
• Private telephone in home.
• Knowledge of the principles and practices of primary medical and nursing care, with working knowledge of oncologic nursing and palliative care.
• Understanding of interpersonal dynamics within an interdisciplinary health care team and knowledge of dying and bereavement processes.
• Working knowledge of the VITAS information system (Vx) and ability to use management reports.
• Two years of supervisory experience or equivalent in a health care organization.

• Bachelor s degree preferred.
• Current and valid RN license to practice in the state where the VITAS program is located.

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