Clinical Market Director (Nurse Practitioner) - Partially Remote
Job Summary
Occupation
Nurse Practitioner
Specialty
Internal Medicine
Salary
$120,000
– $165,000
• yearly
Degree Required
MSN/MSRN
Position Type
Full-Time
Work Environment
Clinic/Private Practice
Location
Virginia, Virginia, United States
Visa Sponsorship
No
Job Description
Last Update:
5/02/24
OPEN POSITION:
- Market Director of Clinical Services
- NP License Required
COMPENSATION:
- Competitive Base Salary, negotiable dependent on experience
- Annual Company-Wide Bonus
- Additional Quality-Based Bonuses
- Malpractice Insurance
- Health / Dental / Vision Insurance
- STD / Life Insurance
- Paid Time Off Package
- CME Allowance
- License / DEA Fees
- 401k
- Details Negotiable
LOCATION:
- Virginia state market
- partially remote
- some in-state travel required
COMPANY PROFILE:
This organization is a Medicare Advantage Institutional Special Needs Health Plan (ISNP) for long-term nursing home residents. The plan covers all medically necessary and preventive services covered under Medicare Parts A, B, and D. They are strongly focused on improving their members' physical, mental, and social well-being through personalized clinical care and therapies. The organization operates an integrated health plan care management platform designed to improve clinical outcomes and reduce unnecessary medical interventions for long-term care beneficiaries in skilled nursing facilities (SNFs). They employ advanced practice providers supported by nurses and other clinical team members to work with facility staff, physicians, and caregivers to manage member care in place. They are currently hiring due to growth.
POSITION DESCRIPTION:
The Market Director of Clinical Services is a nurse practitioner role reporting to the Regional Vice President. The Market Director is responsible for achieving clinical, medical loss ratio, and quality goals and serves as the local market ISNP expert, providing education, support, and coaching of the clinical team. They work in partnership with the local Medical Director and Market Vice President. The Market Director also serves as the risk manager for the local market plan and, overall, is responsible for the clinical performance of the market, including HEDIS / Stars ratings, admissions per 1k, documentation and coding accuracy, medication therapy management (MTM) review rates, and more. Direct reports of the role include, but are not limited to, a Clinical Implementation Manager, Clinical Field Operations Managers, and an RN Implementation Support Coordinator.
The core duties of the role include, but are not limited to:
- manage overall clinical operations and quality functions within the market
- oversee and monitor clinical performance and quality metrics
- ensure clinical program quality excellence and contract compliance
- facilitate HEDIS and STARs/MTM compliance and ensure gaps closures
- ensure APPs are absorbing and closing as appropriate
- make periodic facility rounds to ascertain relationship status, APP integration, etc.
- conduct SNF readiness evaluations
- have oversight authority for delegated entities delivering clinical services
- have oversight authority for the clinical affordability program
- make recommendations for partnership implementations
- create and ensure delivery of standards and policies within budgetary guidelines
- participate in assigned committees and meetings
- run (with account managers) monthly facility meetings with SNF leadership
- provide ongoing clinical reviews of hospitalizations and facility metrics
- review performance metrics / NP scorecards and deliver CAPs in conjunction with the COO
- conduct market‐based hospitalization review meetings
- participate in utilization management meetings and reviews
- participate in quality investigations
- lead clinical performance improvement programs / projects
- develop risk mitigation plans when performance is not on track
- be accountable for market NP and Clinical Manager assimilation and retention
- lead innovation and special projects aimed at improving member outcomes
- develop and implement cost effective clinical staffing plans and training/support programs
- identify risks to effective clinical execution and implement plans to mitigate
- actively participate in marketing, budgeting, and forecast processes
- actively participate in medical cost management initiatives
- where mandated, ensure NPs have collaborative practice agreements in place
The new Market Director will also be responsible for the delivery and review of the annual quality improvement plan and utilization management plan, and affiliated policies, procedures, and staff / vendor training. The Director will actively participate in quality improvement committee meetings and the CCIP program.
REQUIREMENTS:
- active Virginia NP license with certification
- 5+ years clinical practice experience
- 2+ years experience with SNFs, LTC facilities, etc.
- 1+ year clinical leadership experience
- previous experience with clinical quality programs, utilization management, etc.
- experience leading and managing clinical affordability initiatives
HOW TO APPLY:
To apply for this position, please send your CV to Jenn Kunkel at [Register to View] or call [Register to View] .
Please visit [Register to View] for a full list of available opportunities with CHS Recruiting.
- Market Director of Clinical Services
- NP License Required
COMPENSATION:
- Competitive Base Salary, negotiable dependent on experience
- Annual Company-Wide Bonus
- Additional Quality-Based Bonuses
- Malpractice Insurance
- Health / Dental / Vision Insurance
- STD / Life Insurance
- Paid Time Off Package
- CME Allowance
- License / DEA Fees
- 401k
- Details Negotiable
LOCATION:
- Virginia state market
- partially remote
- some in-state travel required
COMPANY PROFILE:
This organization is a Medicare Advantage Institutional Special Needs Health Plan (ISNP) for long-term nursing home residents. The plan covers all medically necessary and preventive services covered under Medicare Parts A, B, and D. They are strongly focused on improving their members' physical, mental, and social well-being through personalized clinical care and therapies. The organization operates an integrated health plan care management platform designed to improve clinical outcomes and reduce unnecessary medical interventions for long-term care beneficiaries in skilled nursing facilities (SNFs). They employ advanced practice providers supported by nurses and other clinical team members to work with facility staff, physicians, and caregivers to manage member care in place. They are currently hiring due to growth.
POSITION DESCRIPTION:
The Market Director of Clinical Services is a nurse practitioner role reporting to the Regional Vice President. The Market Director is responsible for achieving clinical, medical loss ratio, and quality goals and serves as the local market ISNP expert, providing education, support, and coaching of the clinical team. They work in partnership with the local Medical Director and Market Vice President. The Market Director also serves as the risk manager for the local market plan and, overall, is responsible for the clinical performance of the market, including HEDIS / Stars ratings, admissions per 1k, documentation and coding accuracy, medication therapy management (MTM) review rates, and more. Direct reports of the role include, but are not limited to, a Clinical Implementation Manager, Clinical Field Operations Managers, and an RN Implementation Support Coordinator.
The core duties of the role include, but are not limited to:
- manage overall clinical operations and quality functions within the market
- oversee and monitor clinical performance and quality metrics
- ensure clinical program quality excellence and contract compliance
- facilitate HEDIS and STARs/MTM compliance and ensure gaps closures
- ensure APPs are absorbing and closing as appropriate
- make periodic facility rounds to ascertain relationship status, APP integration, etc.
- conduct SNF readiness evaluations
- have oversight authority for delegated entities delivering clinical services
- have oversight authority for the clinical affordability program
- make recommendations for partnership implementations
- create and ensure delivery of standards and policies within budgetary guidelines
- participate in assigned committees and meetings
- run (with account managers) monthly facility meetings with SNF leadership
- provide ongoing clinical reviews of hospitalizations and facility metrics
- review performance metrics / NP scorecards and deliver CAPs in conjunction with the COO
- conduct market‐based hospitalization review meetings
- participate in utilization management meetings and reviews
- participate in quality investigations
- lead clinical performance improvement programs / projects
- develop risk mitigation plans when performance is not on track
- be accountable for market NP and Clinical Manager assimilation and retention
- lead innovation and special projects aimed at improving member outcomes
- develop and implement cost effective clinical staffing plans and training/support programs
- identify risks to effective clinical execution and implement plans to mitigate
- actively participate in marketing, budgeting, and forecast processes
- actively participate in medical cost management initiatives
- where mandated, ensure NPs have collaborative practice agreements in place
The new Market Director will also be responsible for the delivery and review of the annual quality improvement plan and utilization management plan, and affiliated policies, procedures, and staff / vendor training. The Director will actively participate in quality improvement committee meetings and the CCIP program.
REQUIREMENTS:
- active Virginia NP license with certification
- 5+ years clinical practice experience
- 2+ years experience with SNFs, LTC facilities, etc.
- 1+ year clinical leadership experience
- previous experience with clinical quality programs, utilization management, etc.
- experience leading and managing clinical affordability initiatives
HOW TO APPLY:
To apply for this position, please send your CV to Jenn Kunkel at [Register to View] or call [Register to View] .
Please visit [Register to View] for a full list of available opportunities with CHS Recruiting.