Lead Nurse Practitioner

Career Center • Boise, ID

9h

About The Position

The Nurse Practitioner is responsible for supporting cost-effective, high-quality health care for patients enrolled in long-term care facilities within a designated region by managing the activities performed by a team of Providers and to support national clinical strategy and leadership. This position is responsible for conducting clinical audits of the providers to ensure excellent delivery of service and verifying that care is administered in accordance with all compliance programs, Medicare, Medicare Advantage, state laws and regulatory compliance, privacy and security. ESSENTIAL JOB DUTIES: To perform this job, an individual must perform each essential function satisfactorily, with or without a reasonable accommodation. Work 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 manage a team of Providers and RN Case Managers who provide care within nursing facilities Ensure all patient services are delivered timely, effectively and within the scope of the plan Collaborate with colleagues to explore innovative delivery models or enhancements to current delivery models and care practices Identify opportunities for process improvements and staff education to produce optimal outcomes Serve as a subject matter expert (SME) on the institutional special needs plans (I-SNP) and care model Collaborate on the development of training materials to support clinical training 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 for improved service delivery Oversee the review and resolution of complaints and grievances Participate in company-wide initiatives to ensure consistency and high-quality in the clinical delivery of care Participate in company-wide quality improvement initiatives across all aspects of the organization Ensure care is provided in compliance with all state laws and regulations Detect, prevent and correct fraud, waste and abuse Other duties as assigned

Requirements

• Ability to work designated schedule, reliable attendance
• Skilled business background
• Proficient leadership skills
• Knowledge of HEDIS and STAR ratings
• Knowledge of Medicare, Medicaid, I-SNP, Nursing Facility and Managed Care
• Proficient knowledge of Microsoft Office applications
• Master’s degree in nursing
• 3 to 5 years’ experience in long-term care or with chronically ill patients
• 3-5 years of practice experience
• 1-3 years management experience in long-term care, home health or chronic condition management preferred
• Vast experience in leadership and business preferred
• Extensive knowledge and experience with Medicare, Medicaid, I-SNP, Nursing Facility and Managed Care preferred
• HEDIS / STARs experience preferred
• APRN or PA license required

Responsibilities

• Work 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 manage a team of Providers and RN Case Managers who provide care within nursing facilities
• Ensure all patient services are delivered timely, effectively and within the scope of the plan
• Collaborate with colleagues to explore innovative delivery models or enhancements to current delivery models and care practices
• Identify opportunities for process improvements and staff education to produce optimal outcomes
• Serve as a subject matter expert (SME) on the institutional special needs plans (I-SNP) and care model
• Collaborate on the development of training materials to support clinical training
• 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 for improved service delivery
• Oversee the review and resolution of complaints and grievances
• Participate in company-wide initiatives to ensure consistency and high-quality in the clinical delivery of care
• Participate in company-wide quality improvement initiatives across all aspects of the organization
• Ensure care is provided in compliance with all state laws and regulations
• Detect, prevent and correct fraud, waste and abuse
• Other duties as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Manager