Dialysis Program Manager Registered Nurse

PURPOSE AND SCOPE:

Manages the provision of quality patient care in an independent home therapy program while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory requirements and programs. Takes the appropriate actions and makes the necessary decisions to ensure the continuity of care and patient and staff safety. Provides direction and guidance to the interdisciplinary team providing care to the Home Therapy patients to ensure that the highest standards of care are provided. Collaborates with the Business Unit management team to grow the assigned Home Therapies program(s).

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Manage the tactical execution of short- and long-term objectives through the coordination of activities with a direct responsibility for results, including costs, operational methods, growth, and quality and staffing.
• Provide leadership, coaching and development plans for all direct reports to maintain an engaged and productive workforce; partnering with Human Resources on employee matters.
• Technically proficient in the specific department and knowledge of industry practice and business principles.  Works on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current industry trends. 
• Experienced leadership required for multi-faceted environment; role primarily focuses on tactical execution.  Receives assignments in the form of objectives and determines how to use resources to meet schedules and goals.
• Program or project responsibility generally within the Home Therapy Department.  Manages the operations of one or more HT Programs, direct impact within assigned area.  Manages the coordination of activities of a section or department with direct responsibility for results, including costs, operational methods, and staffing.  
• Follows processes and operational policies in selecting methods and techniques for obtaining solutions.  Recommends changes to policies and procedures following company protocol as needed.  Ensures that subordinates follow policy and procedures. 
• Frequently interacts with supervisors, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers.
• Participates and presents at meetings with internal and external representatives. Often leading a cooperative effort among members of a project team.
• Interacts with internal departments and external customers; particularly in problem resolution.  Acts as an advisor to subordinate(s) to meet schedules and/or resolve problems. 
• Responsible for hiring, coaching and counseling employees, including performance reviews, disciplinary action and terminations.
• Participates in the development and implements the area strategic plans, goals and objectives ensuring alignment with those of the region, division and company. Implements HT program-specific and area quality goals and action plans in order to achieve quality standards.
• Responsible and accountable for facility maintenance and environmental integrity. Promotes a culture of safety in assigned market.  
• Provide technical guidance.
• Assist with various projects as assigned.
• Other duties as assigned.

PATIENT CARE:

• Directs and manages all aspects of patient care for Home Therapies patients in assigned program from admission through discharge of the patient. Provides direction, guidance and support to staff members to ensure the safe and effective delivery of home therapy support care to patients with End Stage Renal Disease (ESRD). Ensures that the standard of dialysis provided is at least equivalent to that provided to facility patients.
• Oversees the identification and evaluation of candidates for the Home Therapies Program including assessment of patients' home environment if needed.
• Accountable for timely completion of patient care plans by organizing meetings of the health care team to discuss patient care plans and resolve patient problems.
• Maintains and communicates efficient and timely patient schedules to ensure maximization of the facility station efficiency.
• Ensures completion of Initial and Annual Nursing assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures is completed.
• Ensures patients' response to home dialysis treatment therapy is documented according to company policies and procedures and in compliance with pertinent regulatory requirements.
• Ensure appropriate intervention for changes in patient adequacy status and troubleshooting peritoneal and access flow issues are completed per physician orders.
• Identifies and communicates patient related issues to the physician.
• Develops action plans for missed treatments in collaboration with the Medical Director.
• Administers medications as prescribed including algorithm (as appropriate), and document appropriate medical justification if indicated. Responsible for the appropriate recording of controlled substances as required by law.
• Ensures reports of alert/panic and abnormal lab results are communicated to appropriate physician.
• Implements staffing and medical supply models to ensure provision of quality patient care.
• Ensures all educational needs of patient and family are met regarding End Stage Renal Disease (ESRD).
• Ensures education of the patient regarding quality measures, transplant options, modality awareness, and access care, including vascular catheter reduction and adherence to treatment regime.
• Oversees coordination transplant education and assists in transplant workup process.
• Ensures all patients are educated regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedules medications, and fluid as appropriate.
• Oversees the safe, effective and timely training of all home patients and their families/significant others on the safe and effective operation and maintenance (as appropriate), of all home therapies equipment
• Acts as a resource for the patient to address concerns and questions.
• Develops a mechanism or process for acquiring and maintaining knowledge of the specific situation of each patient, including hospitalizations, and any significant change in patient care status.
• In the absence of a Kidney Care Advocate, the HT PM will manage the delivery of the Treatment Options Program. 
• Manages and ensures all physician orders are accurately entered into the Medical Information System and that company policies and government regulations related to the collection, packaging, and delivery of lab specimens and reporting of results are followed.
• Maintains appropriate skill levels with all emergency operational procedures, and initiates CPR and emergency measures in the event of cardiac and/or respiratory arrests when the patient is in the medical office.

STAFF:

• Manages assigned program Home Therapies licensed personnel, direct patient care staff, indirect patient care personnel, and when necessary, technical staff.
• Provides employee education and guidance, and performance related feedback through ongoing informal advice and formally through the annual performance evaluation.
• Manages the Home Therapies staffing through the appropriate hiring, firing and disciplinary actions.
• Ensures completion of new hire orientation and training including mandatory in-services and ICD-9 code training when applicable.
• Collaborates with staff to establish personal goals and provides opportunities for professional growth and training to achieve these goals to ensure clinical competence.
• Conducts regular staff meetings to ensure appropriate communication of area, regional and corporate initiatives and policies and procedures, to educate and monitor staff regarding appropriate patient care techniques and other company and regulatory policies and procedures.
• Responsible for all patient care employees receiving appropriate training according to policy, including training to ensure ongoing compliance with all risk management initiatives. Ensure documentation completed for all annual in- service training.
• Collaborates with all appropriate departments to promote home therapy growth
• Provides written documentation of all disciplinary conferences in accordance with the established personnel policies, and confer with the Director of Operations regarding the nature of the disciplinary decisions.
• Participates in Corporate and Business Unit specific employee recognition and satisfaction programs.
• Creates, maintains and communicates efficient and timely employee schedules according to the needs of the facility.
• Ensure all staff is trained in the principles and concepts and practice Customer Service Model.
• Creates and implements a (CQI) Process Improvement Team that involves staff in problem solving.
• Ensures competency of HT personnel in the operation of all home dialysis therapy-related equipment, including the ability to troubleshoot equipment problems with the patient via telephone.
• Directs staff and patients in the preventive maintenance of home therapy equipment, including water systems and analyses as appropriate.

Additional responsibilities may include focus on one or more departments or locations.  See applicable addendum for department or location specific functions.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

• The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians.
• Travel required between assigned facilities and various locations within the region. Travel to regional, Business Unit and Corporate meetings may be required.
• The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials.

SUPERVISION:

• Responsible for the direct supervision of various levels of Home Therapies RN, Home Therapies LPN, HT Coordinator and HT PCT.  May also have supervisory role over technical as necessary and assigned.

EDUCATION:

• Graduate of an accredited School of Nursing (R.N.) Advanced education preferred. Current appropriate state licensure.

EXPERIENCE AND REQUIRED SKILLS:  

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.