Centene Corporation Medical Management Trainer- Medicaid in Omaha, Nebraska
Position Purpose: Provide hands on training to clinical staff in Medical Management on the various aspects of their job functions and responsibilities including both Case Management and Utilization Management specialties. Provide an avenue of consistent training among the clinical staff; define expectations of each specific role for accountability and facilitate clinical training for the staff along with conducting audits of clinical systems entry and/or processes.
·Develop and conduct clinical education courses, including training for new employees and continuous training as needed
·Develop and maintain complex audit processes and audit tools related to authorizations, appeals, quality, case management, inter-rater reliability and data entry
·Audit established guidelines (e.g. Interqual) for medical necessity
·Analyze training needs and identify, select or develop appropriate training programs including training aids and materials
·Audit staff in accordance with established auditing processes, work with staff to identify and resolve errors in data and reporting, and present findings and recommendations for improvement to management
·Train audit staff in the use of audit tools and identification of patterns or trends that require additional training or corrective action
·Evaluate effectiveness of training programs including cost/benefit analyses
·Research, analyze, and recommend internal/external training programs
·Maintain records of training activities and employee progress
·Assist with revisions to Policy and Procedure and/or work process development
·Participate in Quality and Advisory committees) or provider education meetings
· Associate's degree or equivalent experience in nursing.
· RN or LPN license in the state of NE.
· 3+ year’s experience in nursing, managed care or related field.
· Experience in a medical management related department in a trainer, lead or mentoring role.
· Experience with Case Management and Utilization Management preferred.
· Intermediate to advanced skills using Microsoft PowerPoint, Excel and Word.
· Experience in virtual and in-person training, learning and development including adult learning principles, instructional design methodologies, and learning technologies preferred.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
TITLE: Medical Management Trainer- Medicaid
LOCATION: Omaha, Nebraska
POSITION TYPE: Professional