Clinical Training & Compliance Auditor (Hybrid/Remote)

Blue Cross Blue Shield of Arizona

Arizona

Hybrid

USD 70,000 - 95,000

Full time

8 days ago

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Job summary

Blue Cross Blue Shield of Arizona is seeking a Clinical Trainer and Auditor to design, deliver, and evaluate clinical education for clinical operations staff. Training includes NCQA accreditation, CMS and AHCCCS requirements, New Hire Orientation, and ongoing compliance.

The role requires full-time work with hybrid/onsite/remote options; collaboration with IT and Training teams to optimize CareRadius and related tools. AZ licensure and 2+ years in managed care are preferred.

Qualifications

~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.
Active nursing license to practice in AZ or equivalent licensure.

Responsibilities

Plan, develop, deliver, coordinate and evaluate clinical education for clinical operations programs.
Develop onboarding, annual training, CMS/AHCCCS compliance education and competency tools.
Provide online and live training sessions for remote employees and onsite staff.
Monitor effectiveness of training and report outcomes against quality metrics.
Collaborate with IT and Training & Workforce Development to maximize systems use.
Audit staff performance and maintain documentation for accreditation standards.