Director of Clinical Initiatives

Longevity Health Plan is growing rapidly and is looking to add new talent to our team. Longevity Health Plan currently has operations in Colorado, Florida, Illinois, Michigan, New Jersey, New York, North Carolina, South Carolina, Georgia, Ohio, Texas, and Pennsylvania, with plans to start-up operations in other states in the very near future. Due to our rapid growth, we have an immediate need for a Director of Clinical Initiatives.

Company Overview:
Longevity 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 Longevity Health Plan 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.

The Director of Clinical Initiatives is responsible for leading the optimal delivery of targeted Company‐ wide clinical programs and projects, to quantify impact, and ensure program timelines, deliverables, goals/outcomes are achieved through collaboration and communication with Market Leaders and Regional Vice Presidents. The Director of Clinical Initiatives will develop and oversee a team of RNs, LPNs, and CSAs to ensure appropriate implementation of the model of care and provide quality clinical services to plan members. The Director of Clinical Initiatives will work closely with the Regional Vice Presidents, Vice President of Quality, and Senior Director of Clinical Operations on member facing program design, implementation support strategies, alternative staffing models, and new clinical delivery models such as IESNP.

Key Tasks and Responsibilities:

Responsible for role development, direct oversight, and performance monitoring in collaboration with the market clinical leadership for non‐APP clinical team members including RNs, LPNs, and CSAs.
Develops and deploys strategies in collaboration with Regional Vice Presidents of Clinical Operations and Market Directors of Clinical Services to support implementation activities including administrative member onboarding activities.
Leads the design of documentation within the EMR for RNs, LPNs, and CSAs.
Leverages RN, LPN, and CSA team to support quality initiatives including medication adherence and HEDIS activities.
Clinical program design and oversight for special populations or conditions, such as ESRD.
Design alternative staffing models including weekend, part time, and prn models in collaboration with the market clinical leadership.
Participates and guides the development of the role of the APP in the IESNP program.
Supports internal market expansion and new market expansion through program development when need for additional programs are identified by the clinical leadership team and/or implementation team.
Actively participates in Health Plan Clinical Ops, Quality, Delegated Oversight, and other assigned Committees/meetings.
Creates collaborative, efficient and effective clinical workforce and supporting clinical and operational processes that drive improved outcomes, clinical and financial.
Assists with design and implementation of population health initiatives based on population.
Ensures projects have success metrics, tracking to goals, and outcomes reports.
Oversees supplemental benefit field implementation activities.
Performs other related duties as assigned.

Credentials & Coverage:

Valid Advanced Practice Registered Nurse License in Home State.
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. You will be responsible for providing this proof of coverage on an annual basis. Newly onboarding employees to this job description should contact HR to discuss any adjustments required to meet this coverage.

Education and Training:

Master’s degree in nursing required.
Adult, geriatric, family, acute care, primary care OR hospice and palliative, medical psychiatric nurse practitioner education from an accredited school required.
Licensed as an advanced practice nurse in home state, ANCC or AANP Board certified required.

Knowledge and Experience:

Clinical background working in nursing homes, Clinical Quality Program design, Utilization Management Plan implementation, working in a managed care plan/risk bearing entity required.
Experience leading and managing clinical affordability initiatives required.
Ability to stay on top of trends in the health care industry with particular focus on competitive analysis, growth, innovation, and clinical technology.
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 required.
Effective Project Leadership skills able to deliver on time and meet goals.
Computer proficiency, including Microsoft Office Suite ‐ Smartsheet, Excel, MS Word, Teams, and Power BI required.
Must have strong knowledge of the healthcare community in the assigned market area.
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 that effectively enhance relationships internally and externally.
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 Health Plan policies and procedures, work as a team member, supporting Health Plan programs and services, and represent Longevity Health Plan in a positive professional manner.

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 Plan 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.

Longevity Health Plan offers 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.