Clinical Training & Compliance Auditor

Blue Cross Blue Shield of Arizona; United States; Hybride; USD 70 000 - 110 000; Plein temps

Résumé du poste

Blue Cross Blue Shield of Arizona seeks a Clinical Trainer and Auditor to plan, develop, deliver, and evaluate clinical education programs for health plan clinical operations staff. Training includes NCQA accreditation, New Hire Orientation, Annual Training, Model of Care, and CMS/AHCCCS requirements.

The role requires a nursing or behavioral health license, and experience in NCQA/CMS/AHCCCS activities. The position is full-time with hybrid/onsite/remote options and Arizona residency is

Qualifications

• Three years of clinical care experience.
• Two years in a managed care setting.
• Experience with NCQA Surveys, CMS Program Audit, and/or AHCCCS Operational Review.
• Prior audit experience.
• Active nursing or behavioral health licensure in AZ or appropriate state license.

Responsabilités

• 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 onboarding and annual training.

Connaissances

Clinical care

Managed care

NCQA Audits

CMS Audits

AHCCCS requirements

CareRadius collaboration

Formation

Bachelor degree in Nursing

Outils

CareRadius

Description du poste

Blue Cross Blue Shield of Arizona seeks a Clinical Trainer and Auditor to plan, develop, deliver, and evaluate clinical education programs for health plan clinical operations staff. Training includes NCQA accreditation, New Hire Orientation, Annual Training, Model of Care, and CMS/AHCCCS requirements.

The role requires a nursing or behavioral health license, and experience in NCQA/CMS/AHCCCS activities. The position is full-time with hybrid/onsite/remote options and Arizona residency is