RN-Trainer-Managed Care

Works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

Knowledge/Skills/Abilities
Reviews healthcare service delivery and provides standardized training programs for plan staff to improve quality, control medical costs and ensure compliance with all state and federal regulations and guidelines.
• In collaboration with the integrated Healthcare Services team, responsible for the development, implementation and evaluation of comprehensive educational and training curriculum for all Clinical and Case Management staff.
• Responsible for evaluation and assessment of training effectiveness to ensure staff understanding and readiness. Evaluates the clinical staff skill level and competency in the delivery of the clinical programs in the health plan.
• Responsible for being able to understand and educate staff on state specific regulations and/or contracts. • Adds state-specific content to standardized MHI training materials.
• Serves and/or participates in committees and/or workgroups and evaluates and implements recommendations from the committees that are applicable to staff training.
• Implements training for new staff and ongoing training that will include managed care basics, new process and/ or system implementations, and case management/utilization management standards of practice.

Required Experience
• 3 or more years in case, disease or utilization management; managed care; or medical/behavioral health settings.
• Experience demonstrating knowledge of adult educational/ learning theory and practice.
• Experience working independently and handling multiple projects simultaneously.
• Experience demonstrating knowledge of applicable state, and federal regulations/requirements.




Benefits

We pay most of your benefits costs and in some cases – we pay 100 percent. Most of the benefits not covered by the company are paid with pre-tax payroll deductions. 

• Health insurance
• Dental insurance
• Vision insurance
• Flexible spending accounts (includes health care, dependent care mass transit reimbursement)
• Short- and long-term disability insurance
• Basic Life insurance
• Supplemental AD&D
• Supplemental life insurance
• Wellness Program
• 401(k) retirement with company match
• Employee stock purchase plan
• Vacation, Personal and Sick time
• Paid Company Holidays
• Employee Assistance Program (EAP)
• Training and Learning Opportunities
• Tuition Reimbursement/Educational Assistance
• Service Awards
• On-site fitness center or discount at local fitness centers (most locations)Discounts for select local and national products and services, including cell phones, computers and more