Clinical Training & Compliance Auditor (Hybrid/Remote)

Blue Cross Blue Shield of Arizona; Yuma (AZ); Hybrid; USD 75,000 - 110,000; Full time

Job summary

Blue Cross Blue Shield of Arizona is seeking a Clinical Trainer and Auditor to plan, develop, deliver, coordinate, and evaluate a range of clinical education programs for health plan staff. The role supports training for NCQA accreditation, New Hire Orientation, Annual Training, Model of Care, and CMS/AHCCCS requirements.

The ideal candidate holds a Nursing license in AZ, 2+ years in managed care, and experience with audits and regulatory standards.

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.
• Bachelor degree in Nursing.
• Active, current, and unrestricted nursing license in AZ (or NLC recognition).

Responsibilities

• Plan, develop, deliver, coordinate, and evaluate clinical education programs.
• Provide online and conference call training sessions for remote employees.
• Collaborate with Training and Workforce Development department to meet accreditation requirements.
• Maintain knowledge of NCQA, CMS, and AHCCCS standards and regulatory guidelines.
• Audit staff activities and training effectiveness; develop curricula and tools.

Skills

Training

NCQA knowledge

CMS & AHCCCS familiarity

Coaching & mentoring

Education

Bachelor's degree in Nursing

Tools

CareRadius

Job description

Blue Cross Blue Shield of Arizona is seeking a Clinical Trainer and Auditor to plan, develop, deliver, coordinate, and evaluate a range of clinical education programs for health plan staff. The role supports training for NCQA accreditation, New Hire Orientation, Annual Training, Model of Care, and CMS/AHCCCS requirements.

The ideal candidate holds a Nursing license in AZ, 2+ years in managed care, and experience with audits and regulatory standards.