Clinical Trainer, Auditor

Consults with clinical operations leaders to identify, develop, and respond to training needs and requests Develops curriculum, maintains currency, and revises as appropriate Plan, coordinate, deliver, and evaluate clinical training for clinical operations programs, including: New hire onboarding, Annual Training, Customer service excellence, Quality and performance metrics, Ongoing professional growth, compliance, and regulatory training Serve as a resource for staff in areas of clinical practice, clinical professional development, using coaching, mentoring, effective feedback, and motivation support techniques Serve as subject matter expert on policies and procedures, and desktop procedures related to NCQA, CMS, and

AHCCCS

requirements Utilize a variety of the training methodologies, techniques, concepts, learning tools, and practices Provide online and conference call training session for remote employees Develop valid exercises designed to provide effective hands-on practice to new and existing employees Monitor and report on the effectiveness of education/training programs Create and develop training for employees not able to meet or maintain standards of excellence Develops audit tools that meet NCQA, CMS, and AHCCCS requirements Perform case reviews/audits and IRR analysis, according to standards Audits staff phone calls and written documentation according to policy Conducts periodic audits of documents such as HRA, ETI, Assessments, Care Plans, Medical Necessity Documentation to ensure compliance Provide documentation of staff training according to accreditation and regulatory requirements Collaborate with BCBSAZ Training and Workforce Development department Participate in continuing education and current developments in the field of accreditation, medicine, behavioral health, social determinants of health, and managed care at least annually. Requirements 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 Bachelor degree in Nursing Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN within the first 60 days of hire. Core Competencies Demonstrates expertise in developing and delivering clinical training programs, ensuring compliance with NCQA, CMS, and AHCCCS standards. Proficient in utilizing various training methodologies and conducting audits to maintain high standards of clinical practice. Highest-signal resume keywords Clinical Training Development NCQA Compliance Managed Care Experience Audit Experience Behavioral Health Licensure ATS Optimization Keywords Hard Skills Curriculum Development Training Evaluation Clinical Care Regulatory Training Audit Tools Development Case Reviews Performance Metrics Compliance Documentation Training Methodologies Effective Feedback Techniques Soft Skills Coaching Mentoring Motivational Support Collaboration Effective Communication Certifications & Qualifications Active Nursing License Behavioral Health Professional License Industry Keywords NCQA CMS AHCCCS Managed Care Clinical Operations Continuing Education Social Determinants of Health Accreditation Quality Assurance Performance Improvement #J-18808-Ljbffr Jobtailor