Manager, Clinical - I-SNP/Ohio

Avail HealthCincinnati, OH
Hybrid

About The Position

Avail Healthcare is a Nurse Practitioner–founded organization dedicated to removing barriers to care, access, and meaningful clinical work for Medicare-age individuals. They combine thoughtful technology, strong operational infrastructure, and deep respect for the patient–provider relationship to enable nurse-led virtual and mobile care models. As a fast-growing organization, they are building durable clinical infrastructure to support innovative care programs across multiple states, with a focus on improving outcomes for complex and underserved senior populations. The Manager, Clinical - I-SNP is a clinical leadership role responsible for the performance, quality, and oversight of Nurse Practitioners (NPs) and Registered Nurses (RNs) across Ohio, Indiana, and West Virginia. This team supports Avail Health’s partnership with a Medicare Advantage health plan to support accurate risk adjustment and care management activities for Institutional Special Needs Plan (I-SNP) members residing in long-term care skilled nursing facility settings. The clinical team conducts structured in-person and virtual assessments, producing compliant documentation and actionable insights for the health plan and the member’s Interdisciplinary Care Team. The Manager, Clinical - ISNP directly leads a team of contract mobile NPs delivering Chronic Disease Assessments [CDAs], Health Risk Assessments [HRAs], and Individualized Care Plan [ICP] recommendations. In select regions, contract RNs may independently complete HRA/ICP visits or, less commonly, support telehealth facilitation for NPs. This role is accountable for clinician onboarding, performance management, clinical coaching, and documentation quality to ensure accurate, timely, and compliant delivery of all required services. In close partnership with the Clinical Operations Manager - I-SNP, who oversees scheduling, logistics, and workflow execution, the Clinical Manager – ISNP is responsible for driving clinical excellence across the team, including productivity, assessment quality, and adherence to care model standards, while 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.
  • Company-paid life and disability insurance.
  • 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.
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