APP Clinical Manager

About the role

Join us in transforming healthcare. At Longevity Health, we're dedicated to advancing healthcare through innovation, compassion, and excellence. We're looking for passionate individuals to join our team and help us make a difference.

Responsibilities

• Conduct rounds to each contracted nursing facilities on a regular basis to determine if contracted providers are delivering the Longevity Health Plan Model of Care and are meeting quality and regulatory standards.
• Conducts periodic review meetings with contracted nursing facilities to review clinical and quality results of their ISNP residents’ care, discuss successes and opportunities for improvement and to promote open communication.
• Reviews daily clinical performance metrics and takes action if not on target.
• Provides coaching and coverage for clinical team members as needed.
• Conducts hospitalization reviews and identify root causes and provides coaching and feedback to facilities as part of the monthly clinical review meeting as well as Advanced Practice Providers.
• Facilitates Advanced Practice Providers (APPs - NPs and PAs) onboarding, hiring and conducts facility and clinical orientation.
• Safeguards team performance to targeted goals.
• Builds effective nursing facility relationships to foster LHP program success in the market.
• Works effectively with PCPs and other physicians.
• Safeguards member care coordination activities are well managed including member transitions out of Nursing Facility to community care if needed.
• Escalates issues/concerns that may impact Longevity Health Plan reputation, contract compliance, relationships or any state/regulatory laws/regulations or employment law.
• Works closely with Plan medical director is determining how to enhance/ improve provider quality and appropriateness of care to LHP residents.
• Identifies learning needs of team and works with Director to address.
• Affirms Nursing Facility readiness assessments and ongoing education on Model of Care, and orientation.
• Maintains minimum weekly clinical update calls (currently much more frequent due to COVID) to facilitate interaction and information sharing with colleagues.
• Performs Chart audits as per MOC guidelines for Nurse Practitioners and provides feedback to APPs and MDCS if further interventions are needed for performance improvement.
• Provides 1:1 with APPs on team and provides feedback to APPs, review APP scorecard and provides input on APPs performance appraisal to MDCS.
• Provides MOC oversight for all metrics and develops action plans for each metric and APP and provides education to APPs directly and follow-up to ensure compliance.
• Provides Coaching and 1:1 ACP Mentorship with RP/ family and Members ongoing.
• Provides daily coaching and case reviews with APPs on changes in condition and management of acute and chronic conditions to support Field APP practice.
• Provides APP member coverage for facility onboarding and PTO/sick time away from work as needed.
• Maintains all APP job competencies.
• Supervises and coordinates prior authorizations.
• Facilitates MTM compliance and Communication to team of GAP reports.
• Ensures compliance with all federal and state regulatory requirements-CMS, DOH, BON, HIPAA, MIPPA, Cyber security and LHP policies and procedures.

Requirements

• State unrestricted licensed Advanced Practice Nurse with National Board certification (AANP, ANCC, or AACN) as an Adult, Family, Geriatric or Primary Care nurse practitioner required.
• Will allow acute care nurse practitioner with nursing home/geriatric or hospice palliative experience OR state unrestricted licensed Physician’s Assistant and NCCPA board certified with nursing home/geriatric or hospice/palliative experience.
• DEA License required.
• Must have an active national provider number (NPI) and an active Medicare provider number.
• Valid state driver's license with a good driving record and proof of automobile insurance required.

Qualifications

• Minimum of three (3) years’ experience as an Advanced Practice Provider – Nurse Practitioner or Physician Assistant.
• One (1) year experience in a leadership role and one (1) year experience working in Nursing Facility is strongly preferred.
• Knowledge and philosophical approach to managing patients by treating in most appropriate setting, based on their goals of care.
• Advanced care planning skills, palliative care knowledge.
• Successful experience in influencing a team of care delivery providers to get results.
• Knowledge of applicable State and Federal regulations, Medicare Advantage Institutional Special Needs Plans Model of Care, STARS-Quality Program requirements and other regulations, NCQA requirements.
• Computer proficiency, including Microsoft Office software, ability to learn and successfully utilize electronic medical records and other clinical software.
• Excellent verbal and written communication skills.
• Strong interpersonal skills a must to effectively enhance relationships with the communities we serve, including the internal organization.
• Excellent public presentation skills.
• Highly organized and able to manage multiple projects, people, and deadlines at one time.
• Able to work independently with minimal supervision getting results in a fast-paced environment.
• Ability and willingness to follow policies and procedures, work as a team member, supporting Health Plan programs and services, and represent Longevity Health Plan in a positive professional manner.
• Computer competent—EMR experience, MS Office products, Excel, PPT, Word.

Skills

• Leadership
• Quality Assurance
• Team Management
• Communication
• Healthcare Administration
• Medicare Advantage
• Nursing Home Management
• Palliative Care
• Electronic Medical Records

Benefits

Longevity Health is an Equal Opportunity Employer. We value diversity and encourage applicants of all backgrounds to apply.

Pay

Compensation is commensurate with experience.

Schedule

Hours are flexible to accommodate the needs of the role and the team.