LiveWell Choice, a subsidiary of Longevity Health Plan, is growing and looking to hire a Regional Vice President of Clinical Operations.

Company Overview:

LiveWell Choice is growing rapidly and is looking to add new talent to our team. LiveWell Choice currently has operations in Colorado, Florida, Illinois, Michigan, New Jersey, New York, North Carolina, and Pennsylvania with plans to start up operations in additional states in the very near future. Due to our rapid growth, we have an immediate need for a Regional Vice President of Clinical Operations.

LiveWell Choice offers an integrated health plan care management platform designed to improve clinical outcomes and reduce unnecessary medical interventions for long-term care beneficiaries living in skilled nursing facilities (SNFs). We offer Institutional Special Needs Plans (I-SNP) that are designated Medicare Advantage plans targeted to beneficiaries with Medicare part A & B who require long-term care in institutional settings. Longevity provides an advanced practice practitioner (NP or PA) supported by LHP RNs and other LHP Clinical team members to work with facility staff, physicians, and caregivers to manage member care in place, and improve their clinical outcomes. I-SNP and the Advanced Practitioner Provider/Clinical Team will improve resident and family satisfaction by providing enhanced benefits specifically tailored to the needs of facility residents.

General Purpose: The individual holding this position is required to support and demonstrate their commitment to the LiveWell Choice Statement of Purpose, which is: To improve the health and quality of life of nursing home residents by caring for their unique medical, social, and emotional needs.

Job Description:

Longevity Health Plan (LHP) is first and foremost a clinical company and the Regional Vice President of Clinical Operations (RVPCO) has responsibility for ensuring the best possible delivery of clinical care and services that supports maintenance of the highest level of clinical functioning our members can achieve and in alignment with the members’ goals of care for the assigned markets and cooperate clinical functions. The RVPCO is responsible for leading clinical implementation and operations in their areas of responsibilities to achieve Longevity Health membership and market growth, model of care, quality and financial targets. The RVPCO will ensure systems and processes are in place for the use of appropriate medical services and care. The RVPCO is accountable to refine and execute the highest quality, is efficient and streamlined clinical operating model with end-to-end clinical integration. This individual will design and implement targeted initiatives and strategies to support clinical program success and achieve quality outcomes, working directly with market based and corporate leadership. The RVPCO will supervise the market based Clinical Directors of Quality and Operations and other assigned clinical operations leaders ensuring that established market and corporate functions clinical KPIs are met and clinical staff performance targets/goals are met. The RVPCO will lead planning and execution of an optimal clinical staffing and deployment plan for growing business needs, adjusting as necessary to align with financial and execution targets, timelines. Establishes a culture of compliance and quality. Works collaboratively with market leaders, operations, network, compliance, quality clinical education, director of risk adjustment to ensure all aspects of the LHP Model of Care, Clinical Quality and Risk Adjustment documentation and coding optimization activities and goals are met. Ensures clinical workforce is well prepared, delivers excellent quality and member centered care, builds effective relationships with partner clinical teams, members, PCPs and other care stakeholders while also creating an environment for clinician professional growth and retention. Works with the IT and Clinical Education leaders to ensure optimal deployment of the Longevity Health clinical platform and clinician adoption. Leads clinical innovation and actively facilitates clinical and business operations optimization.

Key Tasks and Responsibilities:

• Puts systems and processes in place to achieve the highest quality and greatest level of support for LHP clinical staff and our SNF building partners. Establishes key performance targets based on budgeted/forecasted market targets for hospitalizations per thousand, medical loss ratio, risk adjustment, clinical staffing, membership growth in conjunction with market leaders and Chief Clinical Officer, DQCOs and develops plans with DQCOs and Implementation Lead to achieve.
• Leads the development and implementation of clinical operations policies and procedures and ensures a strong compliance culture with the clinical workforce. Initiates action when persistent non-compliance is discovered.
• Ensures clinical workforce is adequately prepared and receives ongoing support to deliver optimal clinical, model of care and quality results through working collaboratively with DQCOs and the Clinical Education Leader and other leaders as indicated all in a compliant fashion.
• Established clinical leadership KPI scorecards aligned with clinical program, compliance standards and financial targets and monitors performance to targets on a regular basis. Takes action if performance is not meeting targets/goals.
• Creates a clinical work environment that fosters collaboration, supports autonomous practice, operating discipline, professional growth and development and promotes innovation and loyalty to members and the company.
• Ensures growth and development of clinical leaders in business operations, financial acumen, utilization management, risk adjustment, HEDIS and STARs program.
• Drives clinical performance in closing HEDIS/STARS gaps, Risk Adjustment gaps, clinical program enhancements.
• Visits contracted nursing facilities periodically to assess clinical program impact and relationships.
• Works collaboratively with Utilization management, Compliance and Quality Programs to ensure policies, processes and procedures support LHP goals and are understood by the clinical team/staff are they are adhering to them.
• Creates a process to intake, vet and deploy clinical innovative ideas to meet business challenges, unique member population needs.
• Ensures effective processes are in place to member nursing facility and PCP satisfaction with the clinical workforce and take actions as needed to address concerns.
• Actively participates in clinical leadership and executive meetings bringing the clinical operation needs, input into discussions and action plans.
• Addresses barriers to achieving targets proactively and adjusts as necessary to achieve goals.
• Actively participates on company workgroups, planning sessions and ensures clinical.
• Coach, mentors DQCOs and Clinical Implementation Leads.
• Supports the development of a highly collaborative culture focused on clinical excellence, the highest ethical standards and a major focus on compliance.
• Performs other related duties as assigned.

Licensure/Certification:

• Active, unencumbered Advanced Practice Nurse Practitioner in home state.
• Active ANCC or AANP certified nurse practitioner in any adult/family/geriatric specialty.
• Valid state driver's license with a good driving record required.

Education and Training:

• Minimum MSN as adult, geriatric, primary care, or family nurse practitioner from an accredited college or university.
• MBA is preferred.

Knowledge and Experience:

• 5 years’ progressive leadership skills leading field based clinical provider organization.
• 5 years’ experience working in the nursing home industry.
• 2 years’ experience leading clinical operations for Health Plan Special Needs Plans- Prefer ISNP/IeSNP.
• Exceptional communication written and verbal.
• Exceptional collaboration and team building skills.
• Excellent financial and computer skills, strong financial acumen.
• Demonstrated results, meeting targets, driving high performing teams.
• Demonstrated critical thinking, problem solving and strategic thinking skills.
• Strong financial acumen and demonstrated ability to form budgets, plan staffing needs, execute plans.
• Operating discipline and methodical work skills.
• Compassionate for the member population served, member centric.
• Demonstrated success in engaging, inspiring, leading field clinical teams.
• Excellent organizational and interpersonal skills with friendly and professional demeanor.
• Experience and comfort working within residential setting required.

Due to the requirement for employees in this role to enter nursing homes and provide treatment to the most vulnerable of our population, it is required that the individuals in this role be 100% vaccinated for COVID-19 and receive the booster vaccinations as they become available.

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

LiveWell Choice 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.

LiveWell Choice 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.