Advance Practice Provider Clinical Manager – Nurse Practitioner or Physician Assistant

LiveWell Choice, a subsidiary of Longevity Health Plan, is growing and looking to hire an Advance Practice Provider Clinical Manager – Nurse Practitioner or Physician Assistant - Detroit, Michigan.

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, South Carolina, Georgia, Ohio, Texas, 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 an Advanced Practice Provider Clinical Manager - Nurse Practitioner or Physician Assistant - Detroit, MI.

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.

The Advance Practice Provider Clinical Manager – Nurse Practitioner or Physician Assistant is responsible for overseeing all the day-to-day activities conducted by the clinical delivery providers working in the Longevity Health Plan ISNP nursing facilities. This includes managing local facility relationships, engagement of nursing homes in the Longevity Health Plan Model of Care, training and monitoring assigned Nurse Practitioner individual and overall team performance. The Advance Practice Provider Clinical Manager – Nurse Practitioner or Physician Assistant is responsible for overseeing, scheduling and supporting a team of Nurse Practitioners to execute and deliver the Longevity Health Plan Model of Care, Collaborative Primary Care, Health Plan Clinical Operations and Trusted Advisor/Member Advocate functions and improve the overall quality of care for LHP members. The Advance Practice Provider Clinical Manager – Nurse Practitioner or Physician Assistant works with Director of Clinical Operations and Quality to ensure clinical quality and affordability initiatives are executed effectively and targeted outcomes are achieved. The Advance Practice Provider Clinical Manager – Nurse Practitioner or Physician Assistant may travel to broad geography, depending upon the market to visit nursing facilities and NP/clinical team members.

Key Tasks and 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 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 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.
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.

Licensure:

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

Education and Training:

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

Knowledge and Experience:

Minimum of three (3) years’ experience as a Nurse Practitioner.
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 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.
Computer competent- EMR experience, MS Office products, Excel, PPT, Word.

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.

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.