Purpose This role plays a key part in onboarding, developing, and supporting staff through the creation of training materials and hands-on training with a focus on utilization management and care management systems, including Jiva and other clinical information systems. The person selected for this role will be located in the Pacific or Mountain time zones within the United States. Key responsibilities include:
- Develop and implement training, provide hands-on training for clinical and non-clinical staff including staff demonstration of workflow processes and utilization of the care management system.
- Lead training initiatives for the team in collaboration with leadership.
- Orient and onboard new staff to the CM team through hands-on training and supportive training tools.
- Provide ongoing support to directors and managers by addressing training needs based on identified performance issues.
Education
- Nursing degree, Healthcare Administration, or a related clinical healthcare field (preferred)
- AA degree in an allied health professional field (required)
- Certifications
Licensure:
- Registered Nurse (RN) or Licensed Vocational Nurse (LVN) license (preferred) can be active or non-active but must be in good standing.
- Allied health professional background (PT/OT/SLP etc.) (minimum requirement).
- IQCI Certification (preferred but not required).
Years of Experience
- Minimum 5 years of experience in healthcare delivery or medical management
- At least 5 years of experience in utilization management or related medical management roles
- Minimum 2 years of experience in staff training, education within healthcare.
- Experience with clinical systems (e.g., Jiva, Epic, InterQual/MCG) and utilization management required.
Specialized Knowledge, Skills and Abilities and/or Competencies
- Strong knowledge of healthcare operational and clinical workflows
- Proficient in clinical information systems and care management platforms, especially Jiva
- Deep understanding of utilization management principles, medical necessity criteria, and review methodologies (prospective, concurrent, and retrospective)
- Familiarity with Lean, Six Sigma, or other process improvement methodologies
- Excellent communication skills, with the ability to facilitate training on complex concepts clearly to diverse audiences.
- Proficient in Microsoft Office Suite (Excel, Word, PowerPoint, SharePoint, Visio)
- Skilled in virtual collaboration tools (Teams, Zoom)
- Strong time management, planning, and organizational skills
- Comfortable working both independently and collaboratively in fast-paced environments
- Strong written, verbal communication skills and interpersonal skills.
- Ability to handle more challenging and/or complex requests
Typical Job Duties and Responsibilities
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