Clinical Trainer, Auditor

Jobtailor

Phoenix (AZ)

On-site

USD 70,000 - 90,000

Full time

14 days+

Get more replies from employers

Send a job-specific resume in minutes.

Job summary

Jobtailor seeks an experienced clinical training professional to design and deliver comprehensive training programs for clinical operations. You will develop curricula, coordinate onboarding and annual trainings, and evaluate program effectiveness to ensure alignment with NCQA, CMS, and AHCCCS standards.

You will serve as a subject matter expert in regulatory requirements and provide coaching, feedback, and mentorship to staff, including remote employees, with a keen focus on quality improvement

Qualifications

3 years’ experience in clinical care
2 years of work experience in a managed care setting
Prior experience in NCQA Surveys, CMS Program Audit, and/or AHCCCS Operational Review
Prior audit experience

Responsibilities

Consults with clinical operations leaders to identify, develop, and respond to training needs and requests
Develops curriculum, maintains currency, and revises as appropriate
Plan, coordinate, deliver, and evaluate clinical training for clinical operations programs, including: New hire onboarding, Annual Training, Customer service excellence, Quality and performance metrics, Ongoing professional growth, compliance, and regulatory training
Serve as a resource for staff in areas of clinical practice, clinical professional development, using coaching, mentoring, effective feedback, and motivation support techniques
Serve as subject matter expert on policies and procedures, and desktop procedures related to NCQA, CMS, and AHCCCS requirements
Utilize a variety of the training methodologies, techniques, concepts, learning tools, and practices
Provide online and conference call training session for remote employees
Develop valid exercises designed to provide effective hands-on practice to new and existing employees
Monitor and report on the effectiveness of education/training programs
Create and develop training for employees not able to meet or maintain standards of excellence
Develops audit tools that meet NCQA, CMS, and AHCCCS requirements
Perform case reviews/audits and IRR analysis, according to standards
Audits staff phone calls and written documentation according to policy
Conducts periodic audits of documents such as HRA, ETI, Assessments, Care Plans, Medical Necessity Documentation to ensure compliance
Provide documentation of staff training according to accreditation and regulatory requirements
Collaborate with BCBSAZ Training and Workforce Development department
Participate in continuing education and current developments in the field of accreditation, medicine, behavioral health, social determinants of health, and managed care at least annually.

Skills

Curriculum Development

Training Evaluation

Clinical Care

Regulatory Training

Audit Tools Development

Case Reviews

Performance Metrics

Compliance Documentation

Training Methodologies

Effective Feedback Techniques

Education

Bachelor degree in Nursing

Active Nursing License

Behavioral Health Professional License

Job description

Consults with clinical operations leaders to identify, develop, and respond to training needs and requests
Develops curriculum, maintains currency, and revises as appropriate
Plan, coordinate, deliver, and evaluate clinical training for clinical operations programs, including: New hire onboarding, Annual Training, Customer service excellence, Quality and performance metrics, Ongoing professional growth, compliance, and regulatory training
Serve as a resource for staff in areas of clinical practice, clinical professional development, using coaching, mentoring, effective feedback, and motivation support techniques
Serve as subject matter expert on policies and procedures, and desktop procedures related to NCQA, CMS, and AHCCCS requirements
Utilize a variety of the training methodologies, techniques, concepts, learning tools, and practices
Provide online and conference call training session for remote employees
Develop valid exercises designed to provide effective hands-on practice to new and existing employees
Monitor and report on the effectiveness of education/training programs
Create and develop training for employees not able to meet or maintain standards of excellence
Develops audit tools that meet NCQA, CMS, and AHCCCS requirements
Perform case reviews/audits and IRR analysis, according to standards
Audits staff phone calls and written documentation according to policy
Conducts periodic audits of documents such as HRA, ETI, Assessments, Care Plans, Medical Necessity Documentation to ensure compliance
Provide documentation of staff training according to accreditation and regulatory requirements
Collaborate with BCBSAZ Training and Workforce Development department
Participate in continuing education and current developments in the field of accreditation, medicine, behavioral health, social determinants of health, and managed care at least annually.

Requirements

3 years’ experience in clinical care
2 years of work experience in a managed care setting
Prior experience in NCQA Surveys, CMS Program Audit, and/or AHCCCS Operational Review
Prior audit experience
Bachelor degree in Nursing
Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN within the first 60 days of hire.

Core Competencies

Demonstrates expertise in developing and delivering clinical training programs, ensuring compliance with NCQA, CMS, and AHCCCS standards. Proficient in utilizing various training methodologies and conducting audits to maintain high standards of clinical practice.

Highest-signal resume keywords