What are the responsibilities and job description for the Case Management Clinician Trainer position at PacificSource Health Plans?
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PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.
Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.
Provide and/or coordinate all initial new hire training. Identify training department needs and arrange for continued education for all Behavioral Health (BH)/Physical Health (PH) Clinical staff. Develop and maintain desktop and resource materials. Facilitate and coordinate training of clinical mentor, and subject matter expert roles within Health Services. Active participation in policy and desk top reference development.
Essential Responsibilities:
- Develop, maintain, and present training programs in coordination with Health Services Leadership Team which ensure Clinicians are trained to provide exceptional clinical expertise and quality outcomes.
- Develop, organize, and maintain a centralized electronic system of reference tools and training materials, including desktop references and resources.
- Standardize and maintain training materials to reflect current practice & compliance standards both internally as well as within the broader health insurance industry.
- Ensure regulatory compliance with all state and federal guidelines as well as other accrediting entities.
- Work with Health Services Team Leaders in all aspects of training. Identify ongoing training needs for all Clinicians. Develop/maintain appropriate training materials.
- Act as clinical liaison and subject matter expert on the medical management platform. Responsible for managing upgrades, enhancements and change requests within the system related to clinical roles and workflows.
- Assist with quarterly audit processes. Utilize additional evidence-based methodology to ensure staff are able to demonstrate competencies.
- Ensure that each new hire is provided with the tools to successfully begin their new position. Meet with the new employee quarterly for the first year to determine additional educational needs.
- Attend Policy and Procedure meetings and participate in initiating, reviewing and editing of policies when relevant.
- Attend interdepartmental meetings as indicated.
- Utilize lean methodologies for continuous improvement.
- Expertise in identifying, working with, and developing individualized approaches to different adult learning styles and in creating customized trainings/educational modalities for different audiences.
- Practice and model effective communication skills: both written and verbal.
- Maintain working knowledge and understanding of the essential responsibilities of a CM Clinician functions as outlined in a CM Clinician job description.
Supporting Responsibilities:
- Act as backup for other Health Services Department staff and functions as needed.
- Serve on designated committees, teams, and task groups, as directed.
- Represent the Heath Services Department, both internally and externally, as requested by Medical Director or other member of the senior leadership team.
- Meet department and company performance and attendance expectations.
- Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
- Perform other duties as assigned.
SUCCESS PROFILE
Work Experience: Minimum of four (4) years of nursing or clinical behavioral health experience with varied health care exposure and experience required. Six (6) months of experience within PacificSource Health Services Department preferred. Experience in teaching or coaching preferred.
Education, Certificates, Licenses: Registered nurse with current unrestricted state licenses(s) or Licensed Clinical psychologist, LCSW, or comparable behavioral health professional with extensive experience and/or credentials (e.g. Licensed Professional Counselor, PC, Licensed Marriage and Family Therapist LMFT, Psychiatric Mental Health Nurse Practitioner, PMHNP) with current unrestricted state license(s). Certified Case Manager Certification (CCM) as accredited by CCMC (The Commission for Case Management) strongly desired at time of hire. CCM certification required within two years of hire.
Knowledge: Thorough knowledge and understanding of medical (for PH Trainer) and behavioral health processes (for BH Trainer), diagnoses, care modalities, procedure codes including health insurance and state-mandated benefits. Understanding of contractual benefits and options available outside contractual benefits. Working knowledge of community services, providers, vendors and facilities available to assist members. Ability to use computerized systems for data recording and retrieval. Assures patient confidentiality, privacy, and health records security. Establishes and maintains relationships with community services and providers. Thorough knowledge and understanding of adult learning styles. Maintains current clinical knowledge base and certification. Ability to work independently with minimal supervision. Must be able to function as part of a collaborative, cohesive community.
Competencies:
Adaptability
Building Customer Loyalty
Building Strategic Work Relationships
Building Trust
Continuous Improvement
Contributing to Team Success
Planning and Organizing
Work Standards
Environment:
Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 25% of the time.
Skills:
Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for customer service.
- We practice open communication at all levels of the company to foster individual, team and company growth.
- We actively participate in efforts to improve our many communities-internally and externally.
- We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
- We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
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