Remote Clinical Trainer & Auditor - NCQA/CMS Expert

Blue Cross Blue Shield of Arizona; Phoenix (AZ); Hybrid; USD 95,000 - 125,000; Full time

Job summary

Blue Cross Blue Shield of Arizona is seeking a Clinical Trainer and Auditor to plan, develop, deliver, and evaluate diverse clinical education programs for health plan operations. The role supports NCQA, CMS, and AHCCCS requirements and collaborates with leadership to improve staff performance.

The position requires a nursing background with relevant managed care and audit experience, and offers a full-time hybrid work arrangement with on-site and remote duties within Arizona.

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.
• Active, current nursing license in AZ or NLC RN if applicable.

Responsibilities

• Consult with clinical operations leaders to identify training needs and requests.
• Develop curriculum and maintain currency.
• Plan, coordinate, deliver, and evaluate clinical training programs.
• Cover onboarding, annual training, and regulatory requirements.
• Provide online and conference training for remote employees.
• Monitor and report training effectiveness and outcomes.
• Collaborate with the Training and Workforce Development department.

Skills

Excellent communication

Training delivery

Coaching & mentoring

Multitasking & prioritization

Policy interpretation

Education

Bachelor degree in Nursing

Tools

CareRadius

Job description

Blue Cross Blue Shield of Arizona is seeking a Clinical Trainer and Auditor to plan, develop, deliver, and evaluate diverse clinical education programs for health plan operations. The role supports NCQA, CMS, and AHCCCS requirements and collaborates with leadership to improve staff performance.

The position requires a nursing background with relevant managed care and audit experience, and offers a full-time hybrid work arrangement with on-site and remote duties within Arizona.