Physician Practice Operations Director jobs in Sumter, SC

LiveWell Choice, a subsidiary of Longevity Health, is growing and looking to hire an Advanced Practice Provider – Nurse Practitioner or Physician Assistant - Sumter, SC.

General Information: An Advanced Practice Practitioner is a licensed and board-certified nurse practitioner or physician’s assistant specifically assigned to each Longevity Health members for purposes of executing the Institutional Special Needs Plan Model of Care. Advanced Practice Practitioners who require regulatory oversight/supervision will be hired based on the available supervisory/collaborative practice physicians and oversight processes in place in each Longevity Health state.

General Purpose: The individual holding this position is required to support and demonstrate their commitment to the Longevity Health Statement of Purpose, which is: To improve the health and quality of life of nursing home residents by caring for their unique medical, social, and emotional needs.

The APP will be responsible to effectively medically manage a panel of Longevity Health Plan enrolled nursing home level of care/institutional members in partnership with primary care team and deliver the Longevity Health Model of Care. The APP conducts a comprehensive assessment, develops, and delivers the member’s individualized plan of care, attends nursing facility care team meetings, communicates frequently with the resident’s family/loved ones and ensures the care team understands the member’s goals of care and needs. The APP focuses on treating in place, uses clinical practice guidelines to guide treatment decisions and effectively documents member’s health status, functional status, and diagnoses. As part of the Clinical team the APP will be supported by Clinical Manager/Director and local medical director who provide education and guidance on best practices to effectively care for their members.

Key Tasks and Responsibilities:

• Provides collaborative primary care and services to a panel of Longevity Health Services including treating in the most appropriate setting based on the member’s goals of care.
• Executes/delivers Longevity Health Model of Care activities, treating in the most appropriate setting, develops and implements advanced care planning, embraces and executes treating in place model.
• Facilitates, administers Health Plan clinical operations functions- prior authorization, Part A and B services, Medication Reviews, HEDIS and STARs quality gap closure, promoting membership growth.
• Serves as a trusted advisor to members, loved ones and nursing home staff and member advocate, educates care teams on member needs and early identification of changes in condition, notifying NP and telehealth partners for member changes.
• Delivers effective and frequent communication and coordination with members’ PCPs, loved ones and care team members om members care needs, goals of care, treatment plans/changes.
• Supports overall market goals/targets and balances member caseloads demands with other team member support needs.
• Promotes Longevity Health with members, loved ones and nursing facilities and other stakeholders.
• Is able to function autonomously and is accountable for practice.
• Establishes meaningful relationships and is able to effectively function in the nursing home environment.
• Is member centric and customer service orientated establishing meaningful relationships that ensures effective and high-quality care for Longevity Health members.
• Provides support for other important duties as assigned.

Licensure:

• State unrestricted licensed Advanced Practice Nurse, National Board certification (AANP or ANCC) as an Adult, Family, Geriatric or Primary Care nurse practitioner required. Will allow acute care nurse practitioner with nursing home/geriatric or hospice palliative experience OR state unrestricted licensed Physician’s Assistant NCCPA board certified with nursing home/geriatric or hospice/palliative experience
• DEA License required.
• Must be eligible to participate in the Medicare program as a provider and registered.
• Valid state driver's license with a good driving record and proof of automobile insurance required.
• Auto liability insurance declaration page with minimum limits of $100,000/$300,000 for bodily injury and $100,000 for property damage with combined single limit of $300,000. You will be responsible for providing this proof of coverage on an annual basis. Newly onboarding employees to this job description should contact HR to discuss any adjustments required to meet this coverage. 

Other:

• Must have an active national provider number (NPI) and an active Medicare provider number.

Education and Training:

• Master of Science in Nursing as a Nurse Practitioner from a nationally accredited program OR Master’s Degree from an nationally accredited program.

Knowledge and Experience:

• Minimum of 6 months experience as a Nurse Practitioner/Physician’s Assistant AND has some experience with geriatric/hospice or palliative care population prior to becoming an NP/PA OR is a licensed and board-certified new graduate NP/PA supervised by an experienced NP/PA in the LHP New Graduate Fellowship program for 6 months and successfully completes all competencies for independent practice as an LHP APP.
• Experience working in the nursing home environment is strongly desired.
• Computer/Technology proficiency required.
• The ability to engage and communicate effectively with physicians, patients, family members - excellent people skills.
• Self-directed but functions well in a team environment.
• Excellent clinical skills – assessment, diagnosis, treatment, prescribing specifically for the chronically ill population.
• Can function independently, demonstrated critical thinking skills, organization, and prioritization skills.

Company Overview:

Founded in 2018, Longevity Health started as an Institutional Special Needs Plan (ISNP), a type of Medicare Advantage health plan that addresses significant unmet needs of long-term institutionalized members who reside in nursing homes.  Through rapid growth from 2018 to 2022, we expanded our market footprint and currently offer ISNP Medicare Advantage plans in Colorado, Florida, Illinois, Michigan, New Jersey, New York, and North Carolina. 

In 2023, we expanded our service offerings to the broader health plan market.  In addition to our existing markets where we are both the ISNP and the care management team, we are now partnering with National Carriers on their offered ISNP plans in Ohio, Pennsylvania, upstate New York, Georgia, South Carolina, and Texas, with implementations in progress for several other additional US states. This allows us to utilize our core skills of supporting clinical post-acute needs of this vulnerable senior population Currently 13 markets and expanding rapidly..

Company Disclaimers:

Longevity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.

It is the policy of Longevity Health to follow Federal and / or State regulations surrounding COVID vaccinations.  While CMS guidelines have been relaxed, there are some LHP facilities which will still require staff be vaccinated in an effort to protect the health of the members / patients we serve.  If your assigned location(s) require all staff to be fully vaccinated, you are required to obtain and / or provide documentation related to your COVID vaccination.  To confirm whether your assigned location(s) require COVID vaccinations, please refer to the Facility Guide Job Aid located on Longevity Health Plan’s intranet site. 

The Company will engage in an interactive process with individuals who cannot be vaccinated for medical or sincerely held religious beliefs to determine if a reasonable accommodation can be made. While an exemption/accommodation may be initially granted, if at any time during employment, it is determined that an exemption/accommodation that has been granted is no longer considered a reasonable accommodation, it can result in employment with the Company ending.

Candidates must meet the Company’s hiring criteria which include a pre-employment background and drug screening.

Longevity Health offers a competitive compensation and benefits package which includes medical, dental, vision, short and long-term disability, life insurance, and 401(k).

Submission of false information during the application process may result in immediate termination of employment without notice.