Nurse Practitioner- Clinical Program Manager - Baton Rouge, United States - TruHealth LLC
Description
About TruHealthTruHealth supplies contracted nurse practitioners and physician assistants to skilled nursing facilities in six states.
TruHealth clinicians collaborate with facility providers and administrators to address the full range of patients' medical, mental health and social needs.
In addition to providing routine healthcare services, TruHealth providers also act as care coordinators for individuals enrolled in Institutional Special Needs Plans (I-SNPs), a type of Medicare plan for nursing home residents.
TruHealth is a division of Franklin, Tennessee-based American Health Partners Inc. To learn more, visitThe purpose of this position is to be responsible for supporting cost-effective, high-quality health care for patients enrolled in the long-term care facilities in their region by managing the activities of a team of Providers and supports national clinical strategy and leadership.
The Program Manager is responsible for conducting clinical audits of the providers to ensure excellent service deliver, and that care is administered in accordance with Medicare, Medicare Advantage, and all other compliance programs, state laws and regulatory compliance, privacy and security, detecting, preventing, and correcting fraud, waste, and abuse.
Description of Required Duties and Tasks:
Works closely with the leadership at the long-term care facilities in their region and company leadership to meet the key performance metrics for a market
Directly manages a team of Providers and RN Case Managers who are providing care in nursing facilities
Ensures all patient services are delivered on time and effectively and within the scope of the plan.
Collaborates with colleagues to explore innovative delivery models or enhancements to current delivery models and care practices.
Identifies opportunities for process improvements and staff education to produce optimal outcomes
Serves as a subject matter expert (SME) on the ISNP plan and care model.
Collaborates on the development of training materials to support clinical training
Participates in clinical training initiatives
Collaborates with business leaders to implement new markets and programs
Reviews daily, weekly and monthly management reports to monitor and manage care delivery.
Collaborates with vendors and community organizations for improved service delivery
Oversees the review and resolution of complaints and grievances
Participates in company-wide initiatives to ensure consistency and high-quality in the clinical delivery of care
Participates in company-wide quality improvement initiatives across all aspects of the organization
Required Skills/Education/Experience:
APRN or PA license required
3-5 Years of experience in long term care or chronically ill patients
3-5 years of practice experience needed
1-3 years of management experience in long term care, home health or chronic condition management preferred
Driver's license without restrictions and good driving record
Working knowledge of MS Office including Word, Excel, PowerPoint, SharePoint, and Visio
Strong experience in leadership and business preferred.
Strong background and familiarity with Medicare, Medicaid, ISNP, Nursing Facility and Managed Care preferred
Strong working knowledge of HEDIS/ STARs preferred
Supervisory Responsibilities:
First line supervision and delegation of duties of all the Providers (NPs/PAs) and RN Case Managers in direct clinical care services
Frontline oversight, planning, and delegation of onboarding activities of new employees within the designated region
Responsible for provider relations issues that are not at a regional or corporate level that would affect P&Ps
EQUAL OPPORTUNITY EMPLOYER
Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws.
The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.
Licenses & CertificationsRequiredFamily Nurse PractitionerNurse PractitionerAPRN Advanced Practice RNPhysician Assistant