As part of a person-centered care model, this role will assist in management of daily operations of an interdisciplinary care team. This role will ensure the delivery of outcome based, cost-effective care, by utilizing metric-driven decisions. The primary purpose of this role is to oversee all patient care services and personnel for their assigned team. This role will collaborate with all team members to achieve exceptional outcomes. Assures the development of personnel qualifications and policies Identifies and facilitates professional development needs and competency of staff through home visits with staff to supervise and evaluate clinical performance; identifies and follows through with development plan. Maintains compliance with regulatory agency policies and procedures by providing staff guidance in making clinical and case management decisions that are cost effective and focused on clinical outcomes Accountable for team performance in achieving desired clinical and operational performance measures Utilizes clinical software to identify opportunities for education, most appropriate utilization of services, oversee clinical progression of patients and trend team outcomes and performance. Assures that clinical and functional outcomes are achieved at the highest level possible. Resolves patient care problems collaboratively with internal/external customers - collaborates with peers across the regions. Oversees the daily patient assignments for clinical staff based on client needs and staff competency to maintain team productivity standards; LEAN Daily Management process (Visual Boards) Coordinates referrals and ensures timeliness of SOCs and timeliness of adjunct service delivery. Ensures that an individualized plan of care is developed, implemented, and updated as needed for all patients. Ensures coordination of patient care, including communication with all physicians involved in the plan of care Determines staffing needs and coordinates hiring to meet service demands for assigned geographic areas Hires, trains, coaches, and evaluates staff. This role is also responsible for completion of personnel evaluations according to agency timelines Qualifications: Minimum Requirements Education: Associate degree - Registered Nurse Experience: Field experience as Home Health or Hospice clinician Licensure: Registered nurse with current license to practice in the state of CT Preferred: Bachelor's degree in nursing OASIS and case management certification