RN Clinical Auditor/Trainer
2 weeks ago
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
The Clinical Trainer/Auditor, under the direction of the UM Director, is responsible for training UM clinical staff, by being the primary support for the orientation, job-related training and continuing education. The trainer/auditor is responsible for all aspects of training, including content development using principles of adult learning, updating training materials based on company policies and procedures, regulatory changes, published best practice, clinical guidelines and overall workflow improvement strategies. The trainer/auditor is also responsible for conducting of both standard regulatory audits and monitoring of day-to-day processes for the UM team. The trainer/auditor is responsible for assessing overall compliance with policies/processes, as well as trending individual staff performance and reporting findings to the Medical Management team. This position is also responsible for oversight of any coordinator staff assigned to assist in documentation gathering, running reports, meeting management, etc.
Bachelor’s in nursing, required, Master’s preferred
Licensed RN, NY State
5 years of utilization management experience in a managed care or healthcare setting required
2 years’ instructional design and program development experience and familiarity with adult learning concepts preferred
Prior experience delivering classroom and virtual instructor led training preferred
Prior motivational interviewing training experience preferred
Experience using Interqual Guidelines required
Knowledge of the principals surrounding utilization management/organizational determination required
-
Clinical Auditor/Trainer RN
2 weeks ago
New York, New York, United States MJHS Full timeJoin Our Team as a Clinical Auditor/Trainer RNWe are seeking a highly skilled and experienced Clinical Auditor/Trainer RN to join our team at MJHS. As a key member of our Utilization Management (UM) team, you will play a critical role in ensuring the delivery of high-quality healthcare services to our patients and members.Key Responsibilities:Develop and...
-
Clinical Auditor/Trainer
4 months ago
New York, United States MJHS Full timeJob DescriptionJob DescriptionThe challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help...
-
RN Clinical Auditor/Trainer
2 weeks ago
New York, United States MJHS Full timeJob DescriptionJob DescriptionThe challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help...
-
Clinical Auditor/Trainer RN
2 weeks ago
New York, New York, United States MJHS Full timeJob OpportunityMJHS is seeking a highly skilled Clinical Auditor/Trainer RN to join our team. As a key member of our Medical Management department, you will play a critical role in training and auditing our utilization management clinical staff.Key ResponsibilitiesDevelop and deliver training programs for UM clinical staff, incorporating adult learning...
-
Registered Nurse Trainer/Auditor
2 weeks ago
New York, NY, United States MJHS Full timeThe challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life...
-
Clinical Auditor/Trainer
1 week ago
New York, New York, United States MJHS Full timeAbout the RoleThe Clinical Trainer/Auditor will be responsible for training and auditing clinical staff in utilization management, ensuring compliance with company policies and procedures, regulatory changes, and best practices. This role requires a strong background in nursing, utilization management, and instructional design.Key ResponsibilitiesDevelop and...
-
Clinical Athletic Trainer
3 weeks ago
New York, New York, United States Corewell Health Full timeJob SummaryAs a Clinical Athletic Trainer at Corewell Health, you will provide professional assistance and clinical support to healthcare professionals to ensure the delivery of quality, evidence-based healthcare services.Key ResponsibilitiesTriage patients as directed by physicians and other providers.Facilitate efficient and effective patient flow through...
-
Clinical Auditor, Hospital Bill Review
2 weeks ago
New York, New York, United States MedReview LLC Full timeJob Title: Clinical Auditor, Hospital Bill ReviewAt MedReview LLC, we are seeking a highly motivated and experienced registered nurse to join our team as a Clinical Auditor, Hospital Bill Review. As a key member of our Hospital Bill Review Department, you will be responsible for performing bill reviews and chart validations to ensure accuracy and compliance...
-
Clinical Athletic Trainer
2 weeks ago
New York, New York, United States Corewell Health Full timeJob SummaryAs a Clinical Athletic Trainer at Corewell Health, you will play a vital role in providing professional assistance and clinical support to healthcare professionals to ensure the delivery of quality, evidence-based healthcare services.Key ResponsibilitiesTriage patients as directed by physicians and other providers.Facilitate efficient and...
-
Claims Quality Auditor
1 week ago
New York, New York, United States MetroPlusHealth Full timeJob Title: Claims Quality AuditorMetroPlusHealth is seeking a highly skilled Claims Quality Auditor to join our team. As a Claims Quality Auditor, you will be responsible for reviewing claims to determine if payments have been made correctly. This position analyzes data used in settling claims to determine the validity of payment of claims and reports...
-
Nurse Auditor Investigator
7 days ago
New York, New York, United States MultiCare Health System, Inc. Full timeJob Title: Compliance Nurse Investigator AuditorWe are seeking a highly skilled Compliance Nurse Investigator Auditor to join our team at MultiCare Health System, Inc.About the Role:The Compliance Nurse Investigator Auditor will be responsible for conducting compliance audits and investigations, as well as providing clinical expertise to review and analyze...
-
Nurse Auditor Investigator
3 weeks ago
New York, New York, United States MultiCare Health System, Inc. Full timeJob Title: Compliance Nurse Investigator AuditorWe are seeking a highly skilled Compliance Nurse Investigator Auditor to join our team at MultiCare Health System, Inc.About the Role:The Compliance Nurse Investigator Auditor will be responsible for conducting compliance audits and investigations, as well as providing clinical expertise to review and analyze...
-
Clinical Trainer
2 weeks ago
New York, New York, United States Abbott Full timeAbout the RoleAbbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines.As a Clinical Trainer, you will play a critical role in...
-
Claims Quality Auditor
2 weeks ago
New York, New York, United States MetroPlus Health Plan Full timeJob Title: Claims Quality AuditorAt MetroPlus Health Plan, we are committed to delivering high-quality healthcare services to our members. As a Claims Quality Auditor, you will play a critical role in ensuring that our claims processing systems are accurate and compliant with regulatory requirements.Job SummaryThe Claims Quality Auditor will be responsible...
-
UAS Trainer and Quality Assurance RN
3 weeks ago
New York, New York, United States Compass Healthcare Consulting and Placement Full timeUAS Trainer and Quality Assurance RN Job DescriptionCompass Healthcare Consulting & Placement is seeking an experienced Registered Nurse (RN) to fill a Hybrid position as a UAS Trainer / Quality Assurance UAS Review RN. The ideal candidate will have prior UAS-NY RN experience, an active HCS account, and the ability to train other Registered Nurses on UAS-NY...
-
Market Based Clinical Trainer
3 weeks ago
New Braunfels, United States Care Now Full timeJob SummaryCareNow is seeking a skilled Clinical Market Trainer to join our team. As a Clinical Market Trainer, you will play a critical role in delivering comprehensive training programs to our clinic-based teams, ensuring they have the expertise and knowledge to provide exceptional patient care.Key ResponsibilitiesLead Training Programs: Design and deliver...
-
EMR Trainer
1 week ago
New York, United States HumanEdge Full timeJob DescriptionJob DescriptionEMR Trainer/Go-Live Support/Credentialed Trainer Upcoming go-live OR Implementation at Hospital in Brooklyn, NY Five Opening for first and second shift at OR SCM Allscripts (Altera) experience a plus Only Local Individuals Hourly pay (No stipends) Flexibility in shifts - Will be requested to take different shift - various days a...
-
Compliance Auditor
3 weeks ago
New York, New York, United States LMHS Full timeCompliance Auditor Job SummaryLicking Memorial Health Systems (LMHS) is a leading non-profit healthcare organization dedicated to improving the health and well-being of our community. We are seeking a Compliance Auditor to join our team and contribute to our mission of patient safety and excellence.Key Responsibilities:Conduct internal audits to ensure...
-
UAS Trainer and Quality Assurance Specialist
4 weeks ago
New York, New York, United States Compass Healthcare Consulting and Placement Full timeUAS Trainer and Quality Assurance SpecialistCompass Healthcare Consulting & Placement is seeking an experienced Registered Nurse to fill a Hybrid position as a UAS Trainer / Quality Assurance UAS Review RN. The ideal candidate will have prior UAS-NY RN experience, an active HCS account, and the ability to train other Registered Nurses on UAS-NY and complete...
-
Athletic Trainer
2 weeks ago
New York, New York, United States HSS Full timeJob Title: Athletic TrainerAt HSS, we are seeking a highly skilled and experienced Athletic Trainer to join our team as a Clinical Specialist for Youth Sports and Injury Prevention. As a key member of our Pediatric Outreach Program, you will be responsible for providing oversight and management of clinical responsibilities, leading injury prevention...