RN Clinical Auditor/Trainer

Req #:

2088

Job ID:

13622

Job Location:

New York, NY

Zip Code:

10040

Category:

Managed Care Nursing

Agency:

Elderplan

Status:

Regular Full-Time

Office:

Office-based

Salary:

$101,503.41 - $126,879.27 per year

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

Why work for MJHS?:

When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No?  You will here!  You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals.  You take care of our patients, residents and health plan members, and we will take care of the rest!

 

Benefits include:

• Sign-on Bonuses OR Student Loan Assistance for clinical staff
• FREE Online RN to BSN and MSN degree programs!
• Tuition Reimbursement for all full and part-time staff
• Dependent Tuition Reimbursement for clinical staff!
• Generous paid time off
• Affordable medical, dental and vision coverage for employee and family members
• Two retirement plans! 403(b) AND Employer Paid Pension
• Flexible spending
• And MORE!

 

MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Responsibilities:

The Clinical Trainer/Auditor, under the direction of the UM Director, is responsible for training UM clinical staff, by being the primary support for the orientation, job-related training and continuing education. The trainer/auditor is responsible for all aspects of training, including content development using principles of adult learning, updating training materials based on company policies and procedures, regulatory changes, published best practice, clinical guidelines and overall workflow improvement strategies. The trainer/auditor is also responsible for conducting of both standard regulatory audits and monitoring of day-to-day processes for the UM team. The trainer/auditor is responsible for assessing overall compliance with policies/processes, as well as trending individual staff performance and reporting findings to the Medical Management team. This position is also responsible for oversight of any coordinator staff assigned to assist in documentation gathering, running reports, meeting management, etc.

Qualifications:

• Bachelor’s in nursing, required, Master’s preferred

• Licensed RN, NY State

• 5 years of utilization management experience in a managed care or healthcare setting required

• 2 years’ instructional design and program development experience and familiarity with adult learning concepts preferred

• Prior experience delivering classroom and virtual instructor led training preferred

• Prior motivational interviewing training experience preferred

• Experience using Interqual Guidelines required

• Knowledge of the principals surrounding utilization management/organizational determination required

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