Referral Management (RN) Traning Manager (Bethesda, MD)

Ivyhill has an immediate need for Referral Management (RN) Training Manager for its Call Center located in Bethesda, MD. The qualified candidate will have overall responsibility for implementing and evaluating the in-house/new hire training for Referral Management Reviewers and managing DOD specific training.

Duties and Responsibilities

• Develop training topics based on monitoring observations, changes to standards, policies, and procedures
• Train, orient and competency assess Referral Management agents to ensure that they will be proficient in performing the Referral duties upon completion of training
• Provide remedial and updated training to staff based on changes in the organization
• Create initial and annual competency assessment for Referral Management staff, ensuring completion after initial training and annual afterwards
• During the annual competency assessment, identify gaps in performance and provide a training plan based on assessment to meet the individual's need
• Must be able to perform all the duties and responsibilities of the RN Team
• Develop and implement Performance Improvement Plans (PIPs) for staff who fail to meet monthly standards
• Develop and coordinate online and in-house training to account for IRMAC staff and the NCR weekly training sessions to ensure all personnel receive adequate training on all topics
• Provide Referral Management training to all incoming staff to be able to review referrals; to include utilizing the SRG and where to locate
• Complete training on the components of a correct review; when to accept, reject and send to the network
• Must be knowledgeable of the MCSC requirements
• Extremely knowledgeable on booking protocols
• When not engaged in training staff, the RN will perform duties of the Referral Management Team
• Extremely knowledgeable on ROFR process
• Must be knowledgeable and able to perform all the duties and requirements of the Referral Registered Nurse
• When not engaged in training, will work as a RN completing all the duties and responsibilities as that of the RN Team Lead
• Complete 1200-1600 Referrals with less than 5 mistakes/month.
  
  
  

Requirements

The qualified candidate must be a Licensed Registered Nurse shall possess an unencumbered active RN license from a State Board of Nursing and graduated from an accredited nursing program.

Must have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management (UM) experience is preferred. Full-time employment in a nursing field within the last 24 months is mandatory.

Additionally, the qualified candidate must:

• Be a U.S. Citizen
• Be knowledgeable and have the skills and computer literacy to interpret and apply medical care criteria, such as InterQual, Milliman Ambulatory Care Guidelines, Specialty Referral Guidelines (SRGs) or other evidence-based guidelines identified by the MHS
• Be proficient in the usage and understanding of medical terminology, MHS, VA-DOD Sharing Program, TRICARE, HIPAA, release of medical information.
• Have demonstrated ability to manage a high-performing and efficient team
• Have excellent oral and written communication skills, interpersonal skills, superior customer service, leadership, and organizational skills.
• Have a working knowledge of computers, specifically the Internet, Microsoft Word, Microsoft PowerPoint, Microsoft Access, Microsoft Excel, and Windows
  
  
  

Benefits

Ivyhill has a competitive benefits program which includes medical, dental and vision; Life and AD&D insurance; Short- and Long-Term Disability; supplemental Life insurance and a 401(k) Plan.

Ivyhill is an equal opportunity employer. In compliance with Federal and State Equal Opportunity Laws, qualified applicants are considered for all positions applied for without regard to race, color, religion, sex (including pregnancy and gender identity) , national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, veteran status or any other legally protected status.