APP Clinical Manager

Job Overview Advanced Practice Provider Clinical Manager – Responsible for overseeing daily operations of clinical delivery providers at Longevity Health Plan (LHP) Institutional Special Needs Plan (ISNP) nursing facilities. Manages facility relationships, engages nursing homes in the LHP Model of Care, trains and monitors Nurse Practitioners (NPs) and Physician Assistants (PAs), and supports the team in delivering collaborative primary care, clinical operations, and member advocacy. Works with the Medical Director of Clinical Services (MDCS) to ensure quality, affordability, and outcome targets. May travel regionally to visit facilities and team members. Key Tasks and Responsibilities Conduct rounds at contracted nursing facilities regularly to assess delivery of the LHP Model of Care and compliance with quality and regulatory standards. Hold periodic review meetings with facilities to discuss clinical and quality results, highlight successes, and identify improvement opportunities. Monitor daily clinical performance metrics; take corrective action when targets are missed. Provide coaching and coverage for clinical team members, including PTO and time‑away support. Perform hospitalization reviews, identify root causes, and deliver feedback to facilities and APPs during monthly clinical review meetings. Onboard, hire, and orient Advanced Practice Providers (APPs – NPs and PAs); oversee facility and clinical orientation. Ensure the team meets targeted goals and builds effective nursing‑facility relationships to secure LHP program success. Collaborate effectively with PCPs and other physicians; coordinate member care transitions from nursing homes to community settings. Escalate issues affecting LHP reputation, contract compliance, or regulatory/policy compliance. Partner with the Plan medical director to enhance provider quality and appropriateness of care for LHP residents. Identify learning needs and work with the Director to address them. Assist with nursing‑facility readiness assessments, ongoing education on the Model of Care, and orientation. Prepare HEDIS/STARs measure reports with APPs and initiate action plans. Maintain weekly clinical update calls (frequency as required) to facilitate information sharing. Conduct chart audits per MOC guidelines for NPs; provide feedback to APPs and MDCS when needed. Provide 1:1 coaching to APPs, review scorecards, and contribute input on performance appraisals. Oversee MOC metrics, develop action plans, educate APPs, and ensure compliance. Offer daily coaching and case reviews with APPs for acute and chronic condition management. Provide APP coverage for facility onboarding and PTO/sick time as required; meet all APP job competencies. Coordinate prior authorizations and facilitate MTM compliance and team communication of GAP reports. Track and update APP employment requirements—TB test, flu shot, licensure, certification, DEA license. Perform additional related duties as assigned. Supervisory Responsibilities Achieve department objectives by supervising staff and monitoring work processes. Recruit, select, orient, and train employees; provide growth opportunities. Coach staff with direction from MDCS; appraise performance and schedule training. Implement and enforce systems, policies, and procedures. Maintain a safe, healthy work environment and adhere to legal regulations. Develop schedules, assign tasks, and monitor productivity; resolve operational problems. Control expenses by monitoring budgets, expenditures, and variances; enact corrective actions. Enforce quality and customer‑service standards. Contribute to team effort through related activities as needed. Manage the hospital tracker: record transfers, returns, review notes, and Skill Part A/B services. Provide post‑review education on takeaways and dispositions. Review HEDIS, STARS, and MTM with APPs; track metrics and support field APP education. Ensure compliance with federal and state regulatory requirements—CMS, DOH, BON, HIPAA, MIPPA, Cybersecurity, and LHP policies. Credentials & Coverage State‑unrestricted licensed Advanced Practice Nurse with National Board certification (AANP, ANCC, or AACN) in Adult, Family, Geriatric, or Primary Care; or Acute‑care NP with nursing‑home/geriatric or hospice/palliative experience; or State‑unrestricted licensed Physician Assistant with NCCPA board certification and nursing‑home/geriatric or hospice/palliative experience. DEA license required. Active national provider number (NPI) and Medicare provider number. Valid state driver’s license with good driving record and proof of automobile insurance. Auto‑liability insurance declaration page with minimum limits of $100,000 bodily injury, $300,000 for liability, $100,000 property damage, and combined single limit of $300,000. Education and Training Master of Science in Nursing (MSN) as an NP from a nationally accredited program; or Master’s Degree from a nationally accredited program. Knowledge and Experience Minimum of three (3) years as an Advanced Practice Provider (NP or PA). One (1) year in a leadership role and one (1) year working in a nursing facility (preferred). Experience in nursing homes or supervising staff in such settings; understanding of clinical quality programs, utilization management, and managed care for complex populations. Philosophy of treating patients in the most appropriate setting based on goals of care. Advanced care planning and palliative care competency. Effective team leadership and the ability to influence care delivery providers. Knowledge of state and federal regulations, CMS, DOH, BON, HIPAA, MIPPA, and NCQA requirements. Computer proficiency: Microsoft Office, EMR systems, data analysis, and marketing data compilation. Strong verbal and written communication, interpersonal, and public presentation skills. Highly organized; able to manage multiple projects, people, and deadlines independently. Willingness to follow policies and procedures, act as a team member, support health‑plan programs, and represent Longevity Health Professionally. EMR experience and basic Office software competency (Excel, PowerPoint, Word). Company Overview Longevity Health is a national provider of Institutional Special Needs Plans (I‑SNP), established in 2018 to meet the complex healthcare needs of nursing home residents. The company continually expands across the United States, building strategic partnerships to deliver high‑quality, patient‑centered care. 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; applicants must provide proof of vaccination or an approved exemption where applicable. How to 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 Longevity Health