Manager, Clinical - I-SNP/Ohio

Avail Health•Cincinatti, OH

1d•Hybrid

About The Position

Avail Healthcare is a Nurse Practitioner–founded organization focused on improving care, access, and clinical work for Medicare-age individuals through nurse-led virtual and mobile care models. They are rapidly expanding their clinical infrastructure to support innovative care programs across multiple states, aiming to enhance outcomes for complex and underserved senior populations. The Manager, Clinical - I-SNP is a clinical leadership position responsible for the performance, quality, and oversight of Nurse Practitioners (NPs) and Registered Nurses (RNs) in Ohio, Indiana, and West Virginia. This team collaborates with a Medicare Advantage health plan to facilitate accurate risk adjustment and care management for Institutional Special Needs Plan (I-SNP) members in long-term care skilled nursing facilities. The role involves leading a team of contract mobile NPs and RNs who conduct in-person and virtual Chronic Disease Assessments (CDAs), Health Risk Assessments (HRAs), and develop Individualized Care Plan (ICP) recommendations. Key responsibilities include clinician onboarding, performance management, clinical coaching, and ensuring documentation quality for accurate, timely, and compliant service delivery. This manager will partner closely with the Clinical Operations Manager - I-SNP to drive clinical excellence, productivity, assessment quality, and adherence to care model standards, serving as the primary clinical resource.

Requirements

Master’s or Doctoral degree in Nursing (MSN or DNP) from an accredited program
Current national certification as a Nurse Practitioner (FNP or Adult-Gerontology NP)
Active, unrestricted Nurse Practitioner and Registered Nurse licensure in Ohio, Indiana, and West Virginia, maintained in good standing and in compliance with all applicable state-specific practice regulations throughout the engagement; multi-state licensure required
Minimum 3–5 years of Nurse Practitioner experience working with older adults and/or complex chronic disease populations
Prior experience in a clinical leadership, supervisory, or mentorship role, with demonstrated ability to manage performance and support clinician development
Demonstrated experience defining, tracking, and improving key performance metrics (e.g., productivity, documentation quality, turnaround times)
Strong understanding of Medicare Advantage and I-SNP models, including the clinical and operational complexities of caring for institutionalized, high-acuity populations
Extensive experience in risk adjustment and CMS-HCC documentation, with demonstrated ability to accurately capture and support chronic conditions in alignment with coding and regulatory guidelines
Proven ability to audit clinical documentation for accuracy, completeness, and compliance, including identification of missed or unsupported diagnoses
Experience training, coaching, and upskilling clinicians (NPs/RNs) on risk adjustment principles, documentation standards, and coding accuracy
Strong working knowledge of risk adjustment workflows, audit processes, and feedback loops to drive continuous improvement in documentation quality
Excellent clinical judgment with the ability to assess and support care for complex, high-acuity patient populations, both in clinical practice and a consultative and oversight capacity
Strong communication, organizational, and documentation skills
Comfort with remote work tools, EHR platforms, and technology-enabled care delivery models
Ability to work effectively in a hybrid environment with evolving workflows and processes
Residence in Ohio or Indiana with ability to travel within the assigned region as needed
Ability to work on a primarily Eastern Time Zone schedule, with flexibility for leadership role
Authorization to work in the United States
Valid driver’s license, reliable transportation, and active automobile insurance; must be able to travel within the assigned region and provide proof of insurance upon request
Ability to meet credentialing, privileging, and background check requirements (engagement contingent upon completion)
Completion of WV CARES background screening and receipt of required clearance prior to hire
Compliance with all applicable federal, state, and organizational regulations governing clinical practice

Nice To Haves

Maryland licensure strongly preferred
Experience in geriatrics, long-term care, institutional settings, mobile care, or value-based care models preferred
Familiarity HEDIS/STARs measure and care transitions best practices preferred

Responsibilities

Maintain an active clinical workload aligned with care model expectations, providing CDA, HRA, and ICP services through a combination of regional mobile visits and telehealth support to address coverage needs and ensure timely completion of assessments
Provide clinical leadership, guidance, and support to Nurse Practitioners and Registered Nurses delivering CDA, HRA, and ICP services across assigned markets
Ensure consistent adherence to I-SNP care model standards, clinical protocols, and CMS-aligned documentation requirements
Review and escalate complex and high-risk cases, including patients with polypharmacy, multiple chronic conditions, and functional or cognitive decline
Guide clinical decision-making and appropriate escalation pathways, serving as a first-line resource for challenging cases
Drive consistency in care delivery and clinical judgment across all assigned regions
Lead recruitment, onboarding, and training of contract NPs and RNs to ensure readiness and alignment with care model expectations
Provide ongoing coaching, mentorship, and formal performance management focused on productivity, documentation quality, and clinical accuracy to support growth and accountability
Establish clear performance expectations and accountability for timely, compliant completion of all assessments
Support targeted education and upskilling in geriatric care, risk adjustment, care management, and regulatory requirements
Foster a high-performing, collaborative team culture of clinical excellence with a focus on consistency and accountability
Oversee the accuracy, completeness, and compliance of CDA, HRA, and ICP documentation across the clinical team
Conduct routine chart audits to ensure alignment with CMS guidelines, risk adjustment requirements, and internal quality standards
Provide actionable feedback to clinicians to improve documentation quality, coding accuracy, and clinical clarity
Identify trends and opportunities for improvement in care delivery, documentation practices, workflow efficiency, and drive corrective actions
Educate clinical staff on risk adjustment principles, geriatric syndromes, and evolving regulatory and best practice standards

Benefits

Base salary range of $125,000 – $150,000, depending on experience, scope, and qualifications
401(k) retirement plan with a 2% employer match, subject to plan terms and eligibility requirements
Employees may be eligible for a discretionary performance bonus based on individual performance, role-specific metrics, and overall company performance
Compensation is reviewed annually and may be adjusted based on performance, market data, and organizational factors
Mileage Reimbursement: $0.725 per mile for travel exceeding 30 miles per day, up to $200 per day
Comprehensive benefits include medical, dental, and vision coverage
The company offers a Direct Primary Care (DPC) model paired with a high-deductible health plan and covers 100% of employee medical premiums, with dependent coverage subsidized
Additional benefits include company-paid life and disability insurance, and employer contributions to a Health Savings Account (HSA)
Employees accrue 15 days of paid time off annually, increasing with tenure
8 paid company holidays plus 1 floating holiday annually
Professional liability and malpractice insurance coverage ($1M/$3M) provided