Clinical Auditor/Trainer RN

2 weeks ago


New York, New York, United States MJHS Full time
Job Opportunity

MJHS 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 Responsibilities
  • Develop and deliver training programs for UM clinical staff, incorporating adult learning principles and best practices.
  • Conduct regular audits and monitoring of day-to-day processes to ensure compliance with company policies and procedures.
  • Assess individual staff performance and report findings to the Medical Management team.
  • Oversee coordinator staff assigned to assist with documentation gathering, report running, and meeting management.
Requirements
  • Bachelor's degree in nursing, with a Master's degree preferred.
  • Current RN licensure in New York State.
  • At least 5 years of experience in utilization management in a managed care or healthcare setting.
  • 2 years of experience in instructional design and program development, with familiarity with adult learning concepts.
  • Prior experience delivering classroom and virtual instructor-led training.
  • Prior motivational interviewing training experience.
  • Experience using Interqual Guidelines.
  • Knowledge of utilization management and organizational determination principles.

MJHS offers a dynamic and supportive work environment, with opportunities for professional growth and development. If you are a motivated and experienced Clinical Auditor/Trainer RN, we encourage you to apply for this exciting opportunity.



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