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Trainer - Clinical Services - Utilization Review Focus
Molina Healthcare • San Antonio, TX 78284 • Posted 6 days ago
Trainer - Clinical Services - Utilization Review Focus
Molina Healthcare • San Antonio, TX 78284 • Posted 6 days ago
In-person • Full-time • $29.05-$67.97/hr • Mid Level
**Job Description**
Job Summary
Creates and delivers clinical training programs for clinical staff across the enterprise to orient employees to Molina clinical methodology, along with policies, processes and systems. Ensures all Molina clinical team members are positioned to improve quality, control medical costs, and ensure compliance with state and federal regulations and guidelines. Responsible for the development, implementation, and delivery of training curriculum for Utilization Management, Case Management, and LTSS staff. Leads and manages classes, adapting to trainee skill level, specific backgrounds, changing priorities and operating environments as needed. Training includes clinical new employee orientation, development and delivery for implementations, training and partnerships on clinical initiatives, and optimization efforts.
Job Duties
+ **Design and development of clinical training**
+ Collaborates with team members, managers, and stakeholders to develop and design training content, including identification of goals, objectives, critical success factors and success measures.
+ Serves as a subject matter expert on assigned clinical specialty area. Consults with clinical organizations across Molina to understand clinical business training needs.
+ Develops and tailors clinical content on various topics using clinical expertise gained through previous experience in either UM or CM. Applies critical thinking skills, clinical/professional judgement, and breaks down complex information into simplified categories so it is easier for learners to understand and apply.
+ Creates and uses clinical case scenarios to simulate how training participants will navigate systems and apply their skills and knowledge on the job.
+ Maintains working knowledge of state specific regulations to ensure references and resources are included in training materials.
+ **Preparation and delivery of training**
+ Prepares the learning environment for classroom setup, systems setup, course materials, media, and on-line learning.
+ Educates regarding proper clinical judgment and approaches to decision making. Draws upon previous CM/UM experience to direct trainees and provide them with best practices for working as a member of an inter-disciplinary clinical team.
+ Educates inter-disciplinary / integrated care teams on the best ways to leverage their unique clinical backgrounds and knowledge to effectively collaborate in order to improve member quality of life and to control costs.
+ Train/educate healthcare services staff on professional standards of documentation
+ Reeducate staff via group facilitation and/or individual coaching when deficiencies in performance are identified to mitigate skill gaps.
+ **Evaluation of training & trainee performance**
+ Evaluates training effectiveness to ensure staff understanding and readiness. Analyzes and determines training needs/problems and provides clear and timely verbal and written feedback of issues to team members and management.
+ Participates in committees and/or workgroups as a liaison between the training team and workgroup to ensure alignment with training and influence best practices.
+ **Special Projects**
+ Collaborates and/or leads special projects, such as supporting training efforts for enterprise growth and new clinical programs or systems. Provides post-implementation support, serving as a subject matter expert for trainees to consult with for information and problem solving as the learner begins to apply new skills and knowledge on the job.
Job Qualifications
**REQUIRED EDUCATION** :
Completion of an accredited Registered Nurse (RN) Program and an Associate's or Bachelor's Degree in Nursing.
**OR**
Bachelor's Degree in a social science, psychology, counseling, gerontology, public health, social work, or health related field.
**OR**
LVN/LPN with an additional 4 years of related experience in lieu of a Bachelor's Degree
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
+ 2 or more years in case, disease or utilization management; managed care; or medical/behavioral health settings.
+ One year of training delivery and/or development experience, to include adult learning concepts.
+ Experience working independently and handling multiple projects simultaneously.
+ Experience demonstrating knowledge of applicable state, and federal regulations/requirements.
+ Proficient in MS/Word, Excel, PowerPoint.
**PREFERRED EXPERIENCE** :
5 or more years in case, disease or utilization management; managed care; or medical/behavioral health settings.
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** :
Active, unrestricted State Registered Nursing (RN) or State Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care Quality, or other related certification.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $29.05 - $67.97 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Job Summary
Creates and delivers clinical training programs for clinical staff across the enterprise to orient employees to Molina clinical methodology, along with policies, processes and systems. Ensures all Molina clinical team members are positioned to improve quality, control medical costs, and ensure compliance with state and federal regulations and guidelines. Responsible for the development, implementation, and delivery of training curriculum for Utilization Management, Case Management, and LTSS staff. Leads and manages classes, adapting to trainee skill level, specific backgrounds, changing priorities and operating environments as needed. Training includes clinical new employee orientation, development and delivery for implementations, training and partnerships on clinical initiatives, and optimization efforts.
Job Duties
+ **Design and development of clinical training**
+ Collaborates with team members, managers, and stakeholders to develop and design training content, including identification of goals, objectives, critical success factors and success measures.
+ Serves as a subject matter expert on assigned clinical specialty area. Consults with clinical organizations across Molina to understand clinical business training needs.
+ Develops and tailors clinical content on various topics using clinical expertise gained through previous experience in either UM or CM. Applies critical thinking skills, clinical/professional judgement, and breaks down complex information into simplified categories so it is easier for learners to understand and apply.
+ Creates and uses clinical case scenarios to simulate how training participants will navigate systems and apply their skills and knowledge on the job.
+ Maintains working knowledge of state specific regulations to ensure references and resources are included in training materials.
+ **Preparation and delivery of training**
+ Prepares the learning environment for classroom setup, systems setup, course materials, media, and on-line learning.
+ Educates regarding proper clinical judgment and approaches to decision making. Draws upon previous CM/UM experience to direct trainees and provide them with best practices for working as a member of an inter-disciplinary clinical team.
+ Educates inter-disciplinary / integrated care teams on the best ways to leverage their unique clinical backgrounds and knowledge to effectively collaborate in order to improve member quality of life and to control costs.
+ Train/educate healthcare services staff on professional standards of documentation
+ Reeducate staff via group facilitation and/or individual coaching when deficiencies in performance are identified to mitigate skill gaps.
+ **Evaluation of training & trainee performance**
+ Evaluates training effectiveness to ensure staff understanding and readiness. Analyzes and determines training needs/problems and provides clear and timely verbal and written feedback of issues to team members and management.
+ Participates in committees and/or workgroups as a liaison between the training team and workgroup to ensure alignment with training and influence best practices.
+ **Special Projects**
+ Collaborates and/or leads special projects, such as supporting training efforts for enterprise growth and new clinical programs or systems. Provides post-implementation support, serving as a subject matter expert for trainees to consult with for information and problem solving as the learner begins to apply new skills and knowledge on the job.
Job Qualifications
**REQUIRED EDUCATION** :
Completion of an accredited Registered Nurse (RN) Program and an Associate's or Bachelor's Degree in Nursing.
**OR**
Bachelor's Degree in a social science, psychology, counseling, gerontology, public health, social work, or health related field.
**OR**
LVN/LPN with an additional 4 years of related experience in lieu of a Bachelor's Degree
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
+ 2 or more years in case, disease or utilization management; managed care; or medical/behavioral health settings.
+ One year of training delivery and/or development experience, to include adult learning concepts.
+ Experience working independently and handling multiple projects simultaneously.
+ Experience demonstrating knowledge of applicable state, and federal regulations/requirements.
+ Proficient in MS/Word, Excel, PowerPoint.
**PREFERRED EXPERIENCE** :
5 or more years in case, disease or utilization management; managed care; or medical/behavioral health settings.
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** :
Active, unrestricted State Registered Nursing (RN) or State Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care Quality, or other related certification.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $29.05 - $67.97 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.