RN Clinical Trainer/Auditor - Denver Health Medical Plan (Must Be a Colorado Resident)

Denver Health and Hospital Authority • Denver, CO

19d

About The Position

We are recruiting for a motivated RN Clinical Trainer/Auditor - Denver Health Medical Plan (Must Be a Colorado Resident) to join our team! We are here for life’s journey. Where is your life journey taking you? Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all: Humanity in action, Triumph in hardship, Transformation in health. Department Managed Care Administration Must Be a Colorado Resident Job Summary This position is responsible for developing, delivering, monitoring and maintaining a variety of clinical training programs for the Health Services Department. The position is further responsible for creating comprehensive auditing tools to ensure standardization and consistency of nurse reviewer clinical decisions, compliance to department policies and procedures, and compliance to regulatory standards. Team member is responsible for collaborating with health plan leadership to identify training needs outside of core curriculum to promote maximized effectiveness in managing behavioral and medical costs. The Trainer/Auditor will maintain and monitor the delivery and effectiveness of the training program and identify solutions to challenges. This includes maintaining records of training activities and employees' progress. Will work with audit team to identify and develop training based on the results of audits and corrective actions. Will work with business partners and IT to develop, implement, monitor, and evaluate workplace performance and training solutions. Responsible for coordinating training from external vendors to meet the needs of the department. This position develops, implements and manages learning interventions in support of employee learning and performance related projects. In addition, may need to be a resource to assist/advise Supervisors and/or process authorizations as needed.

Requirements

• Must Be a Colorado Resident
• Bachelor's Degree in Nursing (BSN) required
• 1-3 years comprehensive knowledge of Utilization Management in a managed care environment required
• 1-3 years experience working with Milliman Care Guidelines (MCG), InterQual and/or other clinical criteria/guidelines required
• RN-Registered Nurse - DORA - Department of Regulatory Agencies required
• Strong written and verbal communications.
• Excellent organizational skills and strong attention to detail
• High level of personal accountability and integrity
• Ability to gather, analyze data and prepare informative and accurate reports.
• Ability to understand the workflow of multiple components of the company and to assist in the creation and implementation of integrated policies, procedures, workplans and creative solutions.
• Advanced PC proficiency
• Good working knowledge of regulatory requirements/standards.
• Ability to work with others or independently with minimal supervision

Nice To Haves

• Less than 1 year experience training in a virtual environment desirable
• Less than 1 year clinical training/education and instructional design experience, preferably in managed care , preferred

Responsibilities

• Develop and administer a universal training curriculum for new Health Services employees, as well as ongoing training to maintain identified core competencies (10%)
• Develop training curriculum based on clinical staff knowledge, needs, and areas of improvement needed as identified by senior leadership, staff request, or other business indicators (10%)
• Designs and develops appropriate and effective instructional materials and content for Medical Management systems (Examples: QNXT, Guiding Care MCG, JIRA, etc.) (10%)
• Coordinate training efforts with various cross-functional areas within clinical department (Referral Coordinators, Inpatient and Outpatient Clinical Teams, etc.) (10%)
• Participate in cross functional teams (HPS, Claims, IT, Product, Compliance, etc.) to identify and solve system issues (5%)
• Develop teaching aids such as training handbooks, demonstration models, multimedia visual aids, computer tutorials, and reference works as applicable (10%)
• Serves as an advocate for learning and change management in project planning meetings and effectively communicate project plans, milestones and training strategy on an ongoing basis. Example: System Upgrades (5%)
• Evaluate effectiveness of training programs, including cost and benefit analyses and communicate results to management (10%)
• Audit team results, identify gaps in training and implement improvements in training programs (5%)
• Prepare audit findings, documentation of deficiencies as well as develop final analysis reports for Health Services Department Leadership (5%)
• Responsible for staying abreast of product/member/provider issues, legislation, CMS mandates, policy changes and system changes so they can be considered for training topics (5%)
• Collaborates with Health Services leadership to implement and monitor individual CAPs and/or PIPs as necessary. (5%)
• Assist and advise supervisors as needed. (5%)
• Process authorization requests as needed. (5%)

Benefits

• Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans
• Free RTD EcoPass (public transportation)
• On-site employee fitness center and wellness classes
• Childcare discount programs & exclusive perks on large brands, travel, and more
• Tuition reimbursement & assistance
• Education & development opportunities including career pathways and coaching
• Professional clinical advancement program & shared governance
• Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees