Clinical Systems Trainer

Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin.

Job Summary

The Clinical Systems Trainer is responsible for training staff in the correct and effective use of decision tools used for utilization management activities and assess staff readiness to begin their specific role in the Division at the conclusion of training. As new initiatives and functionalities arise, they work jointly with Clinical Operations leadership to identify training opportunities and implement strategies to ensure ongoing training needs are met. They are responsible for onboarding and orientation of new clinical employees to clinical guideline tools (InterQual); they author guidelines from regulatory requirements or customize from nationally recognized clinical content or organizational criteria to meet CareOregon’s needs. They lead the ongoing training of clinical staff as new guidelines are developed. They develop training and reference materials to ensure staff have the tools needed to streamline operational workflows and overall meet regulatory compliance. They support audit activities as requested.

Essential Responsibilities

• Conduct onboarding training sessions for newly hired clinical staff in utilization management workflows.
• Develop and maintain job aids to support core workflows.
• Facilitate remediation training for identified deviation by individuals and/or teams from policies, procedures, and processes.
• Lead ongoing training refresher sessions for clinical staff.
• Build evaluation of staff training and provides feedback to respective managers.
• Responsible for departmental reporting of aggregate training activities.
• Track all activities which can be used as support documentation for CMS or OHA audits.
• Identifies training opportunities and implements strategies to ensure ongoing training needs are met.
• Assist in internal and external audits as requested.
• Implements strategies to ensure staff comply with internal or external plan of corrections.
• Develop, review, and update clinical content, ensuring accuracy and relevance.
• Ensure all content complies with current clinical standards and regulations.
• Maintain up-to-date knowledge of clinical practices and Medicare and Medicaid guidelines.
• Assist in the development of training materials and educational resources.
• Participate in quality improvement initiatives and projects.
• Design, develop, and update clinical content through the review and understanding of information gathered from regulatory and organizational requirements.
• Collect and incorporate feedback from internal customers to ensure clinical accuracy and usability.
• Perform Quality Assurance testing of clinical content and create and maintain clinical documentation.
• Serve as a clinical resource for both internal customers, including training of new content both created and as part of the product.
• Collaborate with Medical Directors and Clinical Operations leadership team for organizational criteria.
• Participate in developing project plans, monitoring tasks and ensuring on-time delivery of clinical content.

Organizational Responsibilities

• Perform work in alignment with the organization’s mission, vision and values.
• Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization’s strategic goals.
• Adhere to the organization’s policies, procedures and other relevant compliance needs.
• Perform other duties as needed.

Experience and/or Education

Required

• Registered Nurse (RN) license
• Minimum 2 years of clinical experience working with clinical guidelines

Preferred

• Experience in clinical content creation or medical writing
• Experience with InterQual
• Experience with training and onboarding

Knowledge, Skills and Abilities Required

Knowledge

• Proficiency with nationally accepted clinical guidelines, such as InterQual or MCG
• High degree of competence in continual improvement, project management, change management, and program development
• Knowledge of clinical workflows
• Knowledge of learning collaborative and practice facilitation strategies
• Strong computer literacy
• Basic understanding of software development phases

Skills and Abilities

• Ability to work with minimum supervision
• Ability to develop, test, and evaluate programmatic initiatives
• Strong abilities in building relationships with multiple entities
• Excellent written and verbal communication skills
• Ability to work independently and as part of a team
• Strong attention to detail and organizational skills
• Ability to manage multiple projects and meet deadlines
• Strong people management skills, including the ability to coach and motivate teams
• Excellent critical thinking, analytical and problem-solving skills; ability to effectively analyze program goals and objectives to determine successes and opportunities for improvement
• Ability to communicate effectively, both verbally and in writing, including strong presentation and change management skills
• Ability to influence and build consensus
• Ability to work in an environment with matrix reporting
• Ability to work effectively with diverse individuals and groups
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, hear, speak clearly and perform repetitive finger and wrist movement for at least 6 hours/day

• Ability to work effectively with diverse individuals and groups

• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 hours/day

Working Conditions

Work Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure

Member/Patient Facing: No Telephonic In Person

Hazards: May include, but not limited to, physical and ergonomic hazards.

Equipment: General office equipment

Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.

Work Location:Work from home

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Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.