Advanced Practice Provider Clinical Manager

Job Title: Advanced Practice Provider Clinical Manager

LiveWell Choice, a subsidiary of Longevity Health, is seeking an experienced Advanced Practice Provider Clinical Manager to join our team in Albuquerque, NM.

Job Summary:

The Advanced Practice Provider Clinical Manager will oversee the day-to-day activities of our clinical delivery providers working in Longevity Health ISNP nursing facilities. This includes managing local facility relationships, engagement of nursing homes in the Longevity Health Model of Care, training and monitoring assigned Nurse Practitioner and Physician Assistant individuals, and overall team performance.

Key Responsibilities:

• Conduct regular rounds to contracted nursing facilities to ensure contracted providers are delivering the Longevity Health Model of Care and meeting quality and regulatory standards.
• Conduct 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 promote open communication.
• Review daily clinical performance metrics and take action if not on target.
• Provide coaching and coverage for clinical team members as needed.
• Conduct hospitalization reviews and identify root causes, providing coaching and feedback to facilities as part of the monthly clinical review meeting.
• Facilitate Advanced Practice Providers (APPs) onboarding, hiring, and conducts facility and clinical orientation.
• Ensure team performance to targeted goals.
• Build effective nursing facility relationships to foster LH program success in the market.
• Work effectively with PCPs and other physicians.
• Ensure member care coordination activities are well managed, including member transitions out of Nursing Facility to community care if needed.
• Escalate issues/concerns that may impact Longevity Health reputation, contract compliance, relationships, or any state/regulatory laws/regulations or employment law.
• Work closely with Plan medical director to determine how to enhance/improve provider quality and appropriateness of care to LH residents.
• Identify learning needs of team and work with Director to address.
• Assist with Nursing Facility readiness assessments and ongoing education on Model of Care, and orientation.
• Complete HEDIS/STARs measures reports with APPs and initiate actions.
• Maintain minimum weekly clinical update calls to facilitate interaction and information sharing with colleagues.
• Perform Chart audits as per MOC guidelines for Nurse Practitioners and provide feedback to APPs and MDCS if further interventions are needed for performance improvement.
• Provide MOC oversight for all metrics and develop action plans for each metric and APP, and provide education to APPs directly and follow-up to ensure compliance.
• Provide Coaching and 1:1 ACP Mentorship with RP/ family and Members ongoing.
• Provide daily coaching and case reviews with APPs on changes in condition and management of acute and chronic conditions to support Field APP practice.
• Provide APP member coverage for facility onboarding and PTO/sick time away from work as needed.
• Meet all APP job competencies.
• Provide oversight/coordination of prior authorizations.
• Facilitating MTM compliance and Communication to team of GAP reports.
• Initiates, tracks, updates APP employment requirements - TB test, Flu Shot, Licensure, Certification, DEA.

Credentials & Coverage:

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 Physicians 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.

Auto liability insurance declaration page with minimum limits of $100,000/$300,000 for bodily injury and $100,000 for property damage with combined single limit of $300,000.

Education and Training:

Master of Science in Nursing as a Nurse Practitioner from a nationally accredited program OR Master's Degree from a nationally accredited program.

Knowledge and Experience:

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.

Will consider experience working with similar population in another setting.

Clinical background working in nursing homes or supervising staff in nursing homes or working with similar patient populations, clinical quality program implementation, utilization management program policies/procedures, working in a managed care plan with complex vulnerable populations.

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.

Ability to compile and analyze data to be used for management, differentiation, and marketing purposes.

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.

Company Overview:

Longevity Health is a clinical services company and national Institutional Special Needs Plan (ISNP) founded with the purpose of optimizing the quality of life for people in long-term care by focusing on their individualized health needs.

Launched in 2018, our ISNP was designed to address the significant unmet needs of nursing home residents by establishing collaborative, value-based partnerships with long-term care facilities.

Between 2018 and 2022, we experienced rapid growth and expanded our ISNP offerings across several states, including Colorado, Florida, Illinois, Michigan, New Jersey, New York, and North Carolina.

In 2023, we diversified our services by launching as an Independent Provider Association (IPA) in collaboration with leading national health insurers.

This model is now available in Ohio, Pennsylvania, upstate New York, Georgia, South Carolina, Virginia, and Texas, with plans to expand into additional states.

These strategic partnerships allow us to deliver an elevated level of care to this vulnerable population. We are currently active in 13 markets and continue to see steady growth.

Purpose:

The individual holding this position is required to support and demonstrate their commitment to the Longevity Health & LiveWell Choice Statement of Purpose, which is: To optimize the quality of life of people in long-term care by focusing on their individualized health needs through collaborative value-based solutions.

Company Disclaimers:

Longevity Health is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status, or any other characteristic protected by law.

It is the policy of Longevity Health to follow Federal and/or State regulations surrounding COVID vaccinations.

While CMS guidelines have been relaxed, there are some LHP facilities which will still require staff be vaccinated in an effort to protect the health of the members/patients we serve.

If your assigned location(s) require all staff to be fully vaccinated, you are required to obtain and/or provide documentation related to your COVID vaccination.

To confirm whether your assigned location(s) require COVID vaccinations, please refer to the Facility Guide Job Aid located on Longevity Health Plan's intranet site.

The Company will engage in an interactive process with individuals who cannot be vaccinated for medical or sincerely held religious beliefs to determine if a reasonable accommodation can be made.

While an exemption/accommodation may be initially granted, if at any time during employment, it is determined that an exemption/accommodation that has been granted is no longer considered a reasonable accommodation, it can result in employment with the Company ending.

Candidates must meet the Company's hiring criteria which include a pre-employment background and drug screening.

Longevity Health offers a competitive compensation and benefits package which includes medical, dental, vision, short and long-term disability, life insurance, and 401(k).

Submission of false information during the application process may result in immediate termination of employment without notice.

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