Clinical Program Manager

Career Center • St Louis, MO

2d

About The Position

TruHealth supplies contracted nurse practitioners and physician assistants to skilled nursing facilities in six states. TruHealth clinicians collaborate with facility providers and administrators to address patients’ medical, mental health, and social needs. Providers also act as care coordinators for individuals enrolled in Institutional Special Needs Plans (I-SNPs). TruHealth is a division of American Health Partners Inc., based in Franklin, Tennessee.

The Clinical Program Manager supports cost-effective, high-quality care for patients enrolled in long-term care facilities in their region. The role manages a team of providers and supports national clinical strategy and leadership. It conducts clinical audits to promote excellent service delivery and ensure care complies with Medicare, Medicare Advantage, other compliance programs, state laws and regulations, privacy and security requirements, and measures for detecting, preventing, and correcting fraud, waste, and abuse.

The Program Manager works with facility and company leadership to meet market performance metrics; oversees providers and RN Case Managers; monitors care delivery; addresses complaints and grievances; and contributes to training, program implementation, and quality improvement. The role also supervises onboarding and handles provider relations issues within the designated region.

Requirements

• Current APRN or PA license.
• 3–5 years of experience in long-term care or with chronically ill patients.
• 3–5 years of practice experience.
• Unrestricted driver’s license and a good driving record.
• Working knowledge of Microsoft Office, including Word, Excel, PowerPoint, SharePoint, and Visio.

Nice To Haves

• 1–3 years of management experience in long-term care, home health, or chronic condition management.
• Strong experience in leadership and business.
• Strong background and familiarity with Medicare, Medicaid, I-SNP, nursing facilities, and managed care.
• Strong working knowledge of HEDIS/STARs.

Responsibilities

• Work with long-term care facility leadership and company leadership to meet key performance metrics for the market.
• Directly manage Providers and RN Case Managers delivering care in nursing facilities.
• Ensure patient services are delivered on time, effectively, and within the scope of the plan.
• Collaborate with colleagues to explore innovative care delivery models and enhancements to existing models and practices.
• Identify process-improvement and staff-education opportunities to produce optimal outcomes.
• Serve as a subject matter expert on the I-SNP plan and care model.
• Collaborate on developing clinical training materials and participate in clinical training initiatives.
• Collaborate with business leaders to implement new markets and programs.
• Review daily, weekly, and monthly management reports to monitor and manage care delivery.
• Collaborate with vendors and community organizations to improve service delivery.
• Oversee review and resolution of complaints and grievances.
• Participate in company-wide initiatives to promote consistency and high-quality clinical care delivery.
• Participate in company-wide quality-improvement initiatives across the organization.
• Conduct clinical audits to ensure service quality and compliance with applicable requirements.
• Supervise and delegate duties for Providers (NPs/PAs) and RN Case Managers providing direct clinical care.
• Oversee, plan, and delegate onboarding activities for new employees in the designated region.
• Address provider relations issues at the regional level that affect policies and procedures.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed