HOSPICE RN Clinical Manager

Workplace Reviews

Job Description

*Job Summary* The Clinical Manager is the primary safeguard for the agency’s clinical and financial integrity. This role is designed for a high-level clinician who excels at "forensic" documentation review and team accountability. You will ensure that every patient chart tells a clear story of terminality, that care plans are personalized and active, and that all federal reporting—specifically *HOPE submissions*—is accurate and timely to prevent payment delays or ADR triggers. *Key Responsibilities* * *HOPE Assessment & Submission Compliance:* Oversee the transition to and ongoing compliance with the *HOPE (Hospice Outcomes & Patient Evaluation)* tool. Ensure that staff are capturing real-time clinical data during the "pivotal" points of care and that all data is submitted to CMS within the required federal windows. * *Care Plan & Order Management:* Perform daily audits of Physician Orders and Plans of Care (POC). You must ensure that every intervention is tied to a specific diagnosis, that "As Needed" (PRN) orders have clear clinical indications, and that care plans are updated immediately following any change in patient condition. * *Audit-Ready Charting:* Review nursing and IDG narratives to ensure they support the chosen FAST scale level (typically Stage 7 for dementia) and LCD guidelines. You are responsible for identifying and correcting "plateaued" charting that could lead to live discharge scrutiny. * *Admission Gatekeeping:* Review all referral documentation (from sources like Regal) prior to admission. Ensure that the "Certifying Terminal Illness" (CTI) and clinical narratives are in place before the patient is brought on census to protect the agency from technical denials. * *Utilization & Pharmacy Oversight:* Monitor medication orders to ensure alignment with the hospice formulary and clinical necessity. Review high-cost supply usage to ensure "right-sized" care without waste. * *Staff Accountability:* Conduct regular 1-on-1 "Chart Reviews" with field staff to provide corrective feedback on documentation gaps, missed visits, or late order entries. *Qualifications* * *Licensure:* Current California Registered Nurse (RN) license. * *Compliance Expertise:* Proven track record with Hospice Quality Reporting Programs (HQRP) and a deep understanding of the *HOPE assessment tool* requirements. * *Clinical Experience:* 3+ years in Hospice; 1+ years in a supervisory or Lead RN role. * *Detail Obsession:* Ability to identify a missing signature or a vague nursing narrative in a 50-page chart. * *Regulatory Knowledge:* Expert-level knowledge of Medicare Conditions of Participation (CoPs). Pay: $115,000.00 - $125,000.00 per year Benefits: * 401(k) matching * Health insurance * Paid holidays * Paid time off Experience: * Hospice care: 5 years (Required) * Clinical management: 2 years (Required) * Emergency medicine: 2 years (Preferred) * Hospital: 2 years (Preferred) License/Certification: * RN License (Required) Work Location: In person