BPM Lead (Appeals and Grievances Trainer)

UST USource; Pateros; On-site; PHP 100,000 - 400,000; Full time

Job summary

A healthcare training organization is seeking an Appeals and Grievances Trainer in Metro Manila. This role involves creating and facilitating training programs for non-clinical staff, developing training materials, and mentoring new employees. Ideal candidates should have a Bachelor's degree in a related field and a minimum of 2 years experience in US Healthcare appeals and grievances. Strong analytical and communication skills are essential, and a Master's degree is preferred.

Qualifications

• Bachelor’s degree required; Master’s preferred or related experience.
• Minimum 2 years’ experience in US Healthcare appeals & grievances.
• Strong analytical, planning, and problem-solving skills required.

Responsibilities

• Create and facilitate training programs for non-clinical staff.
• Develop and maintain training materials and packages.
• Mentor new employees during the training program.

Skills

Analytical skills

Communication skills

Problem-solving skills

Teamwork

Education

Bachelor’s degree in related field

Master’s Degree in related field

Tools

PowerPoint

Excel

Word

Job description

As an Appeals and Grievances Trainer, you are responsible for creating, organizing and facilitating training program for all non-clinical A&G staff members.

Responsibilities

• Participate & lead in the development, implementation, and updating of training manuals to reflect new approaches to training, departmental and/or system process changes and updates as needed
• Oversee and mentor new employees during the initial training program
• Work closely with the leadership team, QA, and subject matter experts external and internal to assess the learning environment and determine relevant resources for training
• Educate staff in the policies, procedures, as well as an overview of the department, general functions, responsibilities and department relationships with other departments
• Develop and maintain all training materials and develop training packages with related materials assigned by leadership
• Participate in development, testing and implementation of new programs and systems as assigned
• Share performance information with operations and training management to determine next steps
• Coordinate administrative activities with the leadership team, including class evaluations, updating files, class registration, scheduling classes, new hire system/software access, personnel information, and attendance management
• Implement ongoing training for experienced A&G staff members as well as other departments on A&G as needed
• Document outcomes of educational processes and share with leadership
• Assist in performing QA as needed
• Assist with UAT and other implementation tasks as needed
• Perform technical tasks such as creating business requirements documents and user training manuals and guides
• Verify accuracy, consistency, and integrity of data; consult with the operations teams to validate content of reports and documents

Qualifications

• Bachelor’s degree in business administration, Economics, Health Care, Information Systems, Statistics or other related field is required. Master’s Degree in related field preferred. Relevant combination of education and experience may be considered in lieu of degree
• Certification or progress toward certification is highly preferred and encouraged
• Minimum of 2 years’ experience in US Healthcare in appeals & grievances, utilization management, and/or Training experience
• Guiding Care experience is preferred
• Strong analytical, planning, problem solving, verbal, and written skills to communicate complex ideas
• Strong knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.)
• Ability to work independently, within a team environment, and communicate effectively with employees and clients at all levels
• Flexibility and ease with changing tasks and priorities
• Proven problem-solving skills and ability to translate knowledge to corporate departments
• Strong communication skills are required to understand, interpret, and communicate ideas
• Strong analytical, organizational, planning, and problem-solving skills
• Ability to effectively interface with employees at all levels
• Ability to define problems, collect data, establish facts, and draw valid conclusions
• Demonstrated track record of generating results and having an impact on organizations
• Strong focus and drive to serve the customer
• Ability to work in a high-paced environment
• Ability to consistently meet deadlines