Training and Education Coordinator at Partnership HealthPlan of California

Fairfield, California, United States -

Full Time

Start Date

Immediate

Expiry Date

19 Feb, 26

Salary

74.07

Posted On

21 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Training Development, Clinical Nursing, InterQual Certification, Audit Experience, Communication Skills, Organizational Skills, Microsoft Office, Managed Care Knowledge, Regulatory Documentation, Database Systems, Continuing Education Units, Process Improvement, Performance Feedback, Team Collaboration, Patient Care, Data Accuracy

Industry

Insurance

Description

Overview The Training and Education Coordinator will design the training program for the UtilizationManagement (UM) Department’s data platforms, medical necessity software, and departmentpolicies and procedures in consultation with UM Supervisors and Managers Responsibilities ▪ Develops clinical nursing training program courses to include training materials, guides,and schedules training sessions of new UM staff in collaboration with UMSupervisor/Managers and facilitates ongoing training.▪ Conducts training and/or works with other subject matter experts to prepare and conductstrainings for both new staff and ongoing staff development.▪ Maintains training and education records, as needed.▪ Provides training for clinical staff that may include those with Continuing Education Units(CEU).▪ Creates effective written training materials and tools to support learning.▪ Writes and/or provides input on operational desk procedures.▪ Serves as Registered Nurse InterQual Certified Instructors.▪ Reviews and updates job descriptions and department processes.▪ Monitors progress of trainees through one-on-one observation and audit results.▪ Provides feedback to Supervisors and Managers on staff performance relating to accuracyof work and ability to apply lessons.▪ Audits UM Department database systems and procedures.▪ Audits all key operational functions to ensure accuracy levels are maintained▪ Prepares reports of staff results and distributes to staff’s immediate supervisor/manager.▪ Assists in re-training nurses and other staff in need of remediation and supervision.▪ Prepares team audit results trending reports and recommends training sessions based ontrends.▪ Supports auditing activities and recommends training topics for staff based on audit results.▪ Reviews and supports all activities related to auditing, tracking, and documenting staffperformance of operational processes with an emphasis on ensuring data and other workoutput is accurate.▪ Produces audit reports to identify trends for training opportunities.▪ Participates in process improvement activities.▪ May provide back-up to other positions as required, including working as a nursecoordinator role.▪ Other duties as assigned. Qualifications Education and Experience Bachelor’s degree, licensure as a Registered Nurse in the State ofCalifornia, or minimum five (5) years’ experience as a RegisteredNurse preferably in a managed care and knowledge of Medi-Cal; orequivalent combination of education and experience. Licensure as aRegistered Nurse in the State of California. Experience working withdatabase systems. Previous utilization management experience,including work with medical necessity criteria tools preferred. Special Skills, Licenses and Certifications Experience in training and developing training materials and step-bystep guides. Working knowledge of demographic systems. Proficient incomputer applications such as Microsoft Word, Excel, PowerPoint andVisio. Knowledge of managed care concepts, policies, and procedures.Ability to understand, interpret, and prepare documentation related toregulatory requirements. Performance Based Competencies Excellent oral and written communication and interpersonal skills andpatience. Ability to establish and maintain effective workingrelationships and handle sensitive communication with diplomacyAudit experience preferred. Excellent organizational skills with abilityto prioritize assignments, maintain accurate records, and meetdeadlines. Ability to use good judgment in making decisions withinscope of authority and handle sensitive issues with tact and diplomacy. Work Environment And Physical Demands Ability to use a computer keyboard and a 10-key calculator. More than70% of work time is spent in front of a computer monitor. Whenrequired, ability to move, carry, or lift objects of varying size, weighingup to 30 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated. HIRING RANGE: $56.98 - $74.07 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Responsibilities

The Training and Education Coordinator will design and implement training programs for the Utilization Management Department. This includes developing training materials, conducting training sessions, and maintaining education records.