Referral Management Training Manager

4 weeks ago

Bethesda, Maryland, United States Ivyhill Technologies Full time
Job Title: Referral Management Training Manager

Ivyhill Technologies has an immediate need for a Referral Management 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 assess competency of Referral Management Reviewers to ensure they will be proficient in performing the Referral duties upon completion of training.
  • Provide remedial and updated training to staff based on organizational changes.
  • Prepare initial and annual competency assessment for Referral staff, ensuring completion after initial training and annually afterwards.
  • Identify gaps in performance during annual competency assessment and provide a training plan based on the assessment to meet the individuals' needs.
  • Ensure all new personnel have an established account prior to reporting to the IRMAC site for initial training.
  • Perform all the duties and responsibilities of the Referral Management Team.
  • Develop and implement Performance Improvement Plans (PIPs) for Agents who fail to meet monthly standards, to include next steps for coordination with Floor Supervisors and Lead Agents.
  • Develop and coordinate on-line 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, where to locate.
  • Complete training on the components of a correct review; when to accept, reject, and send to the network.
  • Knowledge of the MCSC requirements.
  • Expert knowledge of booking protocols.
  • When not engaged in training staff, the RN will perform duties as the Referral Management Team.
  • Extremely knowledgeable on the 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 RN completing all the duties and responsibilities as that of the RN Team Lead.
  • Complete Referrals with less than 5 mistakes/month.
Requirements:
  • Qualified candidate must be a licensed Registered Nurse with an unencumbered and active RN license from the State Board of Nursing and graduated from an accredited nursing program.
  • License cannot be under investigation nor have any adverse action pending from a Nursing State Board or national licensing/certification agency.
  • All licenses must remain current, valid, and unrestricted during contract employment.
  • Additionally, qualified candidate must:
  • Have U.S. Citizenship.
  • Have three years of clinical nursing experience is required.
  • Have full-time employment in a nursing field within the last 24 months is mandatory.
  • Have three years of clinical nursing experience is required. RM and Utilization Management (UM) experience is preferred.
  • 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.
  • Proficient in the usage and understanding of medical terminology, MHS, VA-DOD Sharing Program, TRICARE, HIPAA, release of medical information.
  • Demonstrated ability to manage a high-performing and efficient team.
  • Excellent oral and written communication skills, interpersonal skills, superior customer service, leadership, and organizational skills.
  • Working knowledge of computers, specifically the Internet, Microsoft Word, Microsoft PowerPoint, Microsoft Access, Microsoft Excel, and Windows.
Benefits:

Ivyhill Technologies 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 Technologies 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.

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