MLTSS Market Trainer - Field NJ

CVS Health

18h•Onsite

About The Position

The MLTSS Market Trainer will service MLTSS Medicaid and MLTSS FIDE SNP programs. They will be responsible for all communication with the State for Training Tracking purposes and external IPRO auditors. The Clinical Educator’s goal is to enhance operational quality by strengthening clinician performance through the provision of targeted education, mentoring, and performance support to clinical staff, ensuring accountability and continuous process improvement. This role will perform root cause analysis on audit results, track and trend audit findings, translate audit findings into actionable coaching and educational interventions, and promote sustained performance improvement. The Clinical Educator will also support the adoption of new and evolving workflows and processes through structured education and ongoing support. By reinforcing best practices and driving behavior change, this role will improve audit outcomes and deliver ongoing education to ensure Clinicians remain current with complex, evolving clinical guidelines.

Requirements

Registered Nurse or LSW with an active license in the State
5 years’ managed care experience, which can include Utilization Management, PreCert, Medicare and Medicaid Lines of Business
Working knowledge of UM review tools (e.g. MCG) and regulatory requirements
Training experience which can include individual coaching, precepting, group training
Ability to innovate and ideate solutions to operational challenges
Ability to effectively communicate
Strong technical skills and proficiency in the utilization of MS office applications including Excel, Word, PowerPoint, Microsoft Teams
Strong organizational and time management skills
Successful completion of the NJ Choice Certification, including: Minimum exam score of 80%, Completion of state training modules and Field mentoring component
Must possess reliable transportation and be willing and able to travel up to 90% of the time
Registered Nurse - BSN Required as well as Active Unrestricted NJ RN License
Licensed Social Worker - Masters Required as well as Active Unrestricted NJ RN License

Nice To Haves

MLTSS CM experience - experience with the elderly and disabled
Demonstrated experience in understanding and application of performance management tools and tactics (data, trending, process improvement)
Quality management experience
Creating QuickBase Reports
Creating PowerPoint presentations
Demonstrate relationship management skills
Motivational Interviewing Champion Certification
Brain-Centric Facilitator Certification
Preceptor Education

Responsibilities

Service MLTSS Medicaid and MLTSS FIDE SNP programs
Be responsible for all communication with the State for Training Tracking purposes and external IPRO auditors
Enhance operational quality by strengthening clinician performance through targeted education, mentoring, and performance support to clinical staff
Ensure accountability and continuous process improvement
Perform root cause analysis on audit results
Track and trend audit findings
Translate audit findings into actionable coaching and educational interventions
Promote sustained performance improvement
Support the adoption of new and evolving workflows and processes through structured education and ongoing support
Reinforce best practices and drive behavior change
Improve audit outcomes
Deliver ongoing education to ensure Clinicians remain current with complex, evolving clinical guidelines

Benefits

Mileage is reimbursed per our company expense reimbursement policy
Comprehensive and competitive mix of pay and benefits
Comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources, based on eligibility
CVS Health bonus, commission or short-term incentive program