Longevity Health Plan/LiveWell Choice’s Statement of Purpose: To improve the health and quality of life of nursing home residents by caring for their unique medical, social and emotional needs.

LiveWell Choice, a subsidiary of Longevity Health Plan is growing and looking to add new talent to our team.   Due to our rapid growth, we have an immediate need for a Nurse Practitioner Clinical Manager to work in the Charlotte, NC area. 

Company Overview

LiveWell Choice of North Carolina is a new Medicare Advantage Institutional Special Needs Health Plan specifically available for long term nursing home residents. Essential to the success of LiveWell Choice of North Carolina is the patient centered Nurse Practitioner clinical model.

Position Summary

The Nurse Practitioner Clinical Manager is responsible for overseeing all of the day-to-day activities conducted by the clinical delivery providers working in the LIveWell Choice of Michigan ISNP nursing facilities. This includes managing local facility relationships, engagement of nursing homes in the LiveWell Choice of North Carolina Model of Care, training and monitoring assigned Nurse Practitioners individual and overall team performance. The Nurse Practitioner Clinical Manager is responsible for overseeing, scheduling and supporting a team of Nurse Practitioners to execute and deliver the LiveWell Choice of North Carolina Model of Care, Collaborative Primary Care, Health Plan Clinical Operations and Trusted Advisor/Member Advocate functions and improve the overall quality of care for LiveWell Choice of North Carolina. The Nurse Practitioner Clinical Manager works with the Director of Clinical Operations and Quality to ensure clinical quality and affordability initiatives are executed effectively and targeted outcomes are achieved. The Nurse Practitioner Clinical Manager will travel extensively between the nearby metro areas to visit nursing facilities and Nurse Practitioners/clinical team members.

Essential Function

• Conduct rounds to each contracted nursing facilities on a regular basis to determine if contracted providers are delivering the LiveWell Choice 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 NPs as needed PTO and time away from work.
• 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 Nurse Practitioners.
• Facilitates Nurse Practitioner onboarding, hiring and conducts Nurse Practitioner facility and clinical orientation.
• Ensures 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.
• Ensures 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 LiveWell Choice 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 LiveWell Choice residents.
• Identifies learning needs of team and works with Director to address.
• Assists with Nursing Facility readiness assessments and ongoing education on Model of Care, and orientation.
• Completes HEDIS/STARs measures reports with NPs, and initiates actions.
• Maintain 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 NPs and DCQO if further interventions are needed for performance improvement.
• 1:1 with NPs on team and provides feedback to NPs, review NP scorecard and provides input on NPs performance appraisal to DCQO.
• Provides MOC oversight for all metrics and develops action plans for each metric and NP and provides education to NPs 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 NPs on changes in condition and management of acute and chronic conditions to support Field NP practice.
• Provides NP member coverage for facility onboarding and PTO/sick time away from work as needed. Meets all NP job competencies.
• Provides oversight/coordination of prior authorizations.
• Facilitating MTM compliance and Communication to team of GAP reports.
• Initiates, tracks, updates NP employment requirements- TB test, Flu Shot, Licensure, Certification, DEA.
• Performs other related duties as assigned.

Education and Training

• Master’s Degree in Nursing with adult, family, primary or geriatric nurse practitioner education required.
• Acute Care Nurse Practitioners with extensive geriatric and/or long-term care experience required.

Experience

• Minimum of three (3) years’ experience as a Nurse Practitioner required.
• 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.
• Successful experience in influencing a team of care delivery providers to get results.
• Computer proficiency, including Microsoft Office software, ability to learn and successfully utilize electronic medical records and other clinical software.
• Computer competent- EMR experience, MS Office products, Excel, PPT, Word.

Licensing/Certification

• Licensed as an advanced practiced nurse in home state, ANCC or AANP Board certified.
• DEA License for practice state.

Knowledge/Skills/Abilities

• 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.
• 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.
• Excellent verbal and written communication skills.
• Strong interpersonal skills a must in order 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.
• Ability to compile and analyze data to be used for management, differentiation, and marketing purposes.

 

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

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

Job Type: Full-time