Clin Ops Educ & Excell Coord (UM focus - auditing and training) (Trainers)

Job Summary :

The Clinical Operations Education & Excellence Coordinator creates and delivers state of the art training to Clinical Operation's employees and monitors the quality and competency of performance through auditing for achieving or exceeding business excellence at CareSource.

Essential Functions :

• Participate in the implementation of the department's training and audit strategy to support the achievement of Care Sources mission and business performance goals and national learning strategy.
• Create, implement and evaluate utilization management and case management training programs and audit tools to support the development of CareSource employees, skills and competencies to help achieve business excellence.
• Utilize a variety of educational media to ensure the right training is available to support the specific needs of multiple diverse audiences within areas of accountability.
• Deliver training that successfully transfers learning from the classroom to the expected job functions and responsibilities of the learner.
• Participate in the installation of new business relevant to area of responsibility and expertise.
• Provide oversight, direction, and support for new staff orientation in conjunction with CSU and UM / CM preceptors
• Contributes / participates in process improvement meetings and initiatives.
• Contribute to the development and implementation of quality improvement plan for utilization and care management providing recommendations based on clinical audit findings
• Develop and train utilization or care management specific education, mentoring and coaching to promote quality and consistency across the clinical ops functions
• Provide 1 : 1 coaching to CM / UM staff to promote consistency across clinical ops roles.
• Review and analyze both automated and manual authorizations requests and decisions for trends.
• Execute quality monitoring reviews of provider requests
• Execute quality monitoring reviews as defined by the Clinical Op's Quality Monitoring Policy and Procedures (SOP's) and e-Manuals
• Assist in identifying and evaluating any risk areas and provide input to the development of process improvements
• Perform quality monitoring procedures, education to staff to define issues
• Pursue development opportunities, including external and internal training, and share information gained with co-workers
• Perform any other job duties as requested

Education and Experience :

Competencies, Knowledge and Skills :

Licensure and Certification :

Working Conditions :

Compensation Range :

55,350.00 - $88,560.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type : Salary

Competencies :

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

Salary : $55,350 - $88,560