Care Management Clinical Trainer

This is a fully remote position, open to applicants in Maine.

📋 Description

• Facilitate and deliver live, virtual, and recorded training sessions for both new employees and current staff on case management programs and processes.

• Partner with leadership to outline, develop, enhance, and oversee departmental clinical workflows.

• Create and update comprehensive job aids, reference materials, and desktop procedures.

• Standardize, evaluate, and manage version control for internal clinical and operational documentation.

• Construct, organize, and sustain the department's SharePoint site along with training resources.

• Integrate NCQA, CMS Medicare, and DHA TRICARE regulatory requirements into training content.

• Review staff documentation following training to identify knowledge gaps and provide necessary remedial coaching.

• Uphold compliance with performance benchmarks while enhancing quality, optimizing costs, and improving patient experiences.

⛳️ Requirements

• A Bachelor’s Degree in Health Science, Nursing, or a related field is mandatory.

• At least 5 years of clinical case management experience within a managed care organization or health insurer with Medicare Advantage is essential.

• Proven experience in facilitating live, virtual, and hybrid classrooms in a corporate healthcare or managed care environment is required.

• Experience in developing QA audit tools, analyzing performance metrics, and formulating remediation plans is necessary.

• Demonstrated understanding of NCQA case management accreditation standards, audit preparations, and HEDIS quality metrics is required.

• Exceptional oral and written communication and presentation skills are essential.

• Strong organizational abilities, independence in work, and prioritization skills are required.

• Proficiency with computers and business applications is necessary.

• Skills in Microsoft Excel, Visio, Word, PowerPoint, Outlook, and Access are required.

• A solid background in adult learning principles and instructional design is essential.

• Proven experience in developing comprehensive training curricula from scratch and simplifying complex medical workflows into easily digestible learning paths is required.

• This position is not eligible for immigration sponsorship.

• A Master’s degree in Nursing, Healthcare Administration, or Public Health is preferred.

• Certification as a Certified Case Manager (CCM) or American Case Management Association (ACMA) is preferred.

• Experience with TRICARE is preferred.

• Proficiency in health IT systems, specialized Case Management platforms, Electronic Health Records, and clinical data analytics reporting tools is preferred.

• Experience in SharePoint administration is preferred.

🏝️ Benefits

• Medical insurance

• Dental insurance

• Vision insurance

• Retirement savings with employer contributions

• Paid time off

• Volunteer time off

• Pie day

• Additional employee benefits

• Possible extra compensation, including incentive or commission-based programs, where applicable