Clinical Trainer & Auditor

This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793. Only applicable for San Francisco Candidates : Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Pride Health is hiring a Clinical Trainer & Auditor- to support our client's healthcare team in Phoenix, AZ.

Job Details:
Schedule: Mon-Fri day shift
Location: Phoenix, AZ
Job Type: Local, on-site
Contract Length: 3 months
Pay Rate: 43-48/hr


Job Duties:

• Review prior authorizations, audit and fix prior to distribution to members and providers
• Consults with clinical operations leaders to identify, develop, and respond to training needs and requests
• Develops curriculum, maintains currency, and revises as appropriate
• Plan, coordinate, deliver, and evaluate clinical training for clinical operations programs
• Serve as a resource for staff in areas of clinical practice, clinical professional development, using coaching, mentoring, effective feedback, and motivation support techniques
• Serve as subject matter expert on policies and procedures, and desktop procedures related to NCQA, CMS, and AHCCCS requirements 
• Utilize a variety of the training methodologies, techniques, concepts, learning tools, and practices
• Provide online and conference call training session for remote employees
• Create and develop training for employees not able to meet or maintain standards of excellence
• Develops audit tools that meet NCQA, CMS, and AHCCCS requirements
• Perform case reviews/audits and IRR analysis, according to standards
• Audits staff phone calls and written documentation according to policy
• Conducts periodic audits of documents such as HRA, ETI, Assessments, Care Plans, Medical Necessity Documentation to ensure compliance

Qualifications

• 3 years’ experience in clinical care
• 2 years of work experience in a managed care setting
• Prior experience in NCQA Surveys, CMS Program Audit, and/or AHCCCS Operational Review
• Prior audit experience  
• RN license OR LCSW, LPC, LISAC LMFT

Interested? Apply Today!


#PHC
#LI-JC3For workers in the United States, PrideGlobal and it's affiliates offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, pet insurance and employee discounts with preferred vendors.

Equal Employment Opportunity
PrideGlobal and it's affiliates are an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance Employment
PrideGlobal and it's affiliates are a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Only applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793.