Clinical Manager

Clinical Manager – WVU Medicine.

Responsible for coordinating Home Health intake, coding, and/or quality review activities to ensure standards for care are met and patient care is rendered via collaboration with staff, physicians, ancillary services, patients, and family.

• Current unencumbered licensure with the WV Board of Registered Professional Nurses, or appropriate state board where services will be provided, as a registered professional nurse OR current multi‑state licensure through the enhanced Nurse Licensure Compact (eNLC).
• Valid driver’s license.
• CPR certification within 30 days of date of hire.
• Home Health coaching certification upon hire or within three months of hire.

• Bachelor’s degree in nursing.

• Two (2) years of Home Health experience.
• Two (2) years of experience in utilization review/chart audit.

• Responsible for the coordination of intake activities in support of Home Health function. Case Managers assigned to support intake activities responsibilities include but are not limited to:
• Obtain and process all referral information, assuring accuracy and completeness.
• Complete intake function correctly at least 95% of the time.
• Obtain authorization as necessary.
• Visit patient prior to discharge at least 95% of the time.
• Describe home health services as needed.
• Provide contact information for home health services prior to discharge.
• Manage face‑to‑face documentation completion.
• Provide timely communication a patient referrals.
• Provide end of month referral reports.
• Accountable for smooth transition from facility to home.
• Maintain strong hand‑off communication 100% of the time.
• Responsible for the coordination of coding activities in support of Home Health function. Case Managers assigned to support coding activities responsibilities include but are not limited to:
• Ensure the proper coding principles are utilized per certification.
• Maintain coding timeline at or below seven days.
• Ensure that all comorbidities are added to 95% of the time.
• Ensure coding is completed by third working day of next month 100% of the time.
• Responsible for completing coding work queues daily.
• Ensure coding completed correctly and timely.
• Maintain ongoing communication to keep management aware of funding specific questions or concerns including staff feedback and key trends.
• Responsible for the coordination of quality activities in support of Home Health function. Case Managers assigned to support quality activities responsibilities include but are not limited to:
• Work with leadership to identify quality focus priorities.
• Ensure that quality audits care completed timely 100% of the time.
• Identify, define, and develop reports for leadership on a monthly basis.
• Maintains a detailed up‑to‑date dashboard showing red/green performance areas.
• Maintain strong communication patterns to leadership, including twice monthly quality review sessions.
• Meet with Home Health staff as needed.
• Responsible for periodic and annual focused quality improvement projects that are detailed, comprehensive and outline both improvement plan and results, including additional opportunities and goals.

• Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized in performing nursing duties throughout the work shift.
• Must be able to lift, move, and position patients of all weights, with varying amounts of assistance in a fair manner on a regular and recurring basis.
• Hearing within a normal range required (e.g., to assess breath sounds, heart sounds, apical pulse, monitors, etc.).
• Visual acuity must be within normal range. Must be able to perform night driving as necessary for patient care.
• Must be able to perform heavy work; exerting in excess of 100 pounds of force occasionally, and/or up to 50 pounds of force frequently, and/or up to 20 pounds of force constantly to move objects.

• Exposure to bodily fluids, human tissues, contagious diseases, sharps, and explosive gases.
• Exposure to toxic gases, fumes, and odors.
• Exposure to high stress and constant…