APP Clinical Manager

Location 11780 US HIGHWAY 1 STE 107N, North Palm Beach, FL, 33408-3074, United States Job Overview Join us in transforming healthcare. At Longevity Health , we’re dedicated to advancing healthcare through innovation, compassion, and excellence. We’re looking for passionate individuals to join our team and help us make a difference. The individual holding this position is required to support and demonstrate their commitment to Longevity Health’s purpose: To optimize the quality of life of people in long-term care by focusing on their individualized health needs. Key Tasks and Responsibilities Conduct rounds to each contracted nursing facility 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. 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 during PTO and time away from work. Conduct hospitalization reviews, identify root causes, and provide coaching and feedback to facilities as part of the monthly clinical review meeting and to Advanced Practice Providers. Facilitate Advanced Practice Providers (APPs) onboarding, hiring, and conduct facility and clinical orientation. Ensure team performance meets targeted goals. Build effective nursing facility relationships to foster LHP 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 or concerns that may impact Longevity Health Plan reputation, contract compliance, relationships, or any state/regulatory laws or employment law. Work closely with Plan medical director to determine how to enhance or improve provider quality and appropriateness of care to LHP residents. Identify learning needs of the 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. Conduct 1:1 coaching with APPs, review APP scorecard, and provide input on APP performance appraisal to MDCS. Provide MOC oversight for all metrics, develop action plans for each metric and APP, and provide education to APPs directly with 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, ensuring all APP job competencies are met. Provide oversight/coordination of prior authorizations. Facilitate MTM compliance and communicate to team of GAP reports. Initiate, track, update APP employment requirements—TB test, Flu Shot, Licensure, Certification, DEA. Perform other related duties as assigned. Supervisory Responsibilities Accomplish department objectives by supervising staff and organizing and monitoring work processes. Maintain staff by recruiting, selecting, orienting, and training employees and developing personal growth opportunities. Accomplish staff job results by coaching with direction from MDCS. Plan, monitor, and appraise job results. Conduct training. Implement and enforce systems, policies, and procedures. Maintain a safe and healthy work environment by enforcing organization standards and adhering to legal regulations. Complete operations by developing schedules, assigning and monitoring work, gathering resources, implementing productivity standards, resolving operations problems, maintaining reference manuals, and implementing new procedures. Control expenses by gathering and submitting budget information, scheduling expenditures, monitoring variances, and implementing corrective actions. Provide quality service by enforcing quality and customer service standards. Contribute to team effort by accomplishing related results as needed. Manage the hospital tracker by inputting all hospital transfers, returns from the hospital, notes from hospital review meetings, and Skill Part A and B services. Provide ongoing education after hospital review meetings on takeaways to APPs and dispositions. Review HEDIS, STARS, and MTMs with the APPs and track them by Market, providing ongoing support for the field APPs and education as needed. Ensure compliance with all federal and state regulatory requirements—CMS, DOH, BON, HIPAA, MIPPA, Cyber security, and LHP policies and procedures. 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. Alternatively, an acute care nurse practitioner with nursing home/geriatric or hospice palliative experience, or a state unrestricted licensed Physician’s 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 insurance coverage as required by your state of residence. New employees must provide proof of coverage prior to hire and on an ongoing basis. 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 a Nursing Facility strongly preferred; experience working with a similar population in another setting will be considered. 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 and procedures, and working in a managed care plan with complex vulnerable populations. Knowledge and philosophical approach to managing patients by treating in the most appropriate setting, based on their goals of care. Advanced care planning skills and 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 and ability to learn and 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 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. Ability and willingness to work independently with minimal supervision to achieve results in a fast‑paced environment. Ability and willingness to follow policies and procedures, work as a team member, support 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 national provider of Institutional Special Needs Plans (I‑SNP), created to meet the complex healthcare needs of nursing home residents. Since our founding in 2018, we’ve expanded our services across several states and formed strategic partnerships to deliver high‑quality, patient‑centered care. We are actively growing, with plans to continue expanding our services nationwide. Longevity Health is an Equal Opportunity Employer. We value diversity and encourage applicants of all backgrounds to apply. COVID‑19 Vaccination Policy Longevity Health follows federal and state regulations regarding COVID‑19 vaccinations. Some facilities may still require staff vaccinations to protect the health of residents. Applicants will be required to provide proof of vaccination, or an approved exemption, where applicable. Apply If you are passionate about healthcare and ready to help us drive change in long‑term care, apply now to join the Longevity Health team! #J-18808-Ljbffr Transformcap