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American Health PartnersPosted 1 month ago

Clinical Program Manager

On-siteIndianapolis, Indiana, United States

Full TimeLarge

Job Summary

Conduct clinical audits of providers to ensure service delivery aligns with Medicare, Advantage, and regulatory compliance standards. Manage a team of Providers and RN Case Managers while collaborating with facility leadership to meet key performance metrics. Explore innovative delivery models, identify process improvements, and serve as a subject matter expert on ISNP plans. Review daily, weekly, and monthly reports to monitor care delivery, oversee complaint resolution, and support company-wide quality improvement initiatives. Requires APRN or PA license with 3-5 years of long-term care experience and 1-3 years of management background.

Required Qualifications

  • APRN or PA license
  • 3-5 Years of experience in long term care or chronically ill patients
  • 3-5 years of practice experience
  • Driver's license without restrictions and good driving record
  • Working knowledge of MS Office including Word, Excel, PowerPoint, SharePoint, and Visio
  • First line supervision and delegation of duties of all the Providers (NPs/PAs) and RN Case Managers in direct clinical care services
  • Frontline oversight, planning, and delegation of onboarding activities of new employees within the designated region
  • Responsible for provider relations issues that are not at a regional or corporate level that would affect P&Ps

Desired Qualifications

  • 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, ISNP, Nursing Facility and Managed Care
  • Strong working knowledge of HEDIS/ STARs

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