Customer Solutions Center Appeals and Grievances Training Specialist II
1 day ago
The Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II is responsible for providing ongoing training on the core processing system, A&G processing procedures, training regulatory changes which will affect established procedures, working with the quality team on quality and performance guidelines, creating and maintaining departmental policy and procedures.
Key Responsibilities- Evaluating initial training and ongoing learning opportunities to achieve consistency, efficiency, and productivity among the staff.
- Applying knowledge and skills to build competencies for the design of training programs that will boost employee's workplace performance in alliance with Enterprise and departmental goals.
- Performing training needs assessments with the department management and leading the design and delivery of curriculum and learning materials to ensure the success of new and current staff.
- Conducting training for Customer Solution Center A&G team in customer service, product operations, and other work processes.
- Maintaining documentation, including database/system updates, training agendas, sign-in sheets, etc. to demonstrate trainee compliance with department requirements.
- Working with key stakeholders to monitor error trends, productivity, and quality standards for the program.
- Identifying gaps in knowledge, skills and abilities, assessing and recommending training/education measures to resolve issues and enhance staff performance.
- Proposing program modifications to enhance performance and positively influence member satisfaction survey results.
- Conducting assessments after training to measure, record, and report feedback on training material and sessions.
- Serving as coach staff to handle problems and concerns as they arise.
- Reviewing and recommending updates on policy and procedure critical to claims process.
- Strong understanding of learning principles and ability to demonstrate in classroom (or virtual classroom) situations.
- Knowledge of CA regulatory guidelines, Medi-Cal guidelines, Medicare guidelines, NCQA requirements.
- Skilled in group facilitation and managing effective discussion and dialogue to enhance the learning experience.
- Strong organizational & analytical skills.
- Ability to conduct effective and engaging presentations in a variety of delivery settings.
- Ability to interpret technical data, processes, operating and maintenance instructions and procedure manuals.
- Must be a strong team player willing to work toward achieving team goals. Must be flexible to meet the changing training needs.
- Professional demeanor. Commitment to Team Culture.
- Excellent written and verbal communications skills.
- Proficient using Word, Excel, Power Point and Access.
- A minimum of 3-5 years of Managed Care, Medicaid, Medicare experience is required.
- A minimum of 3-5 experience in design and delivery (facilitating and coordinating) of training programs.
- Bachelor's Degree in Business Administration or Healthcare Related Field
- In lieu of degree, equivalent education and/or experience may be considered.
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Los Angeles, California, United States CCG Business Solutions, LLC Full timeJob Title: Customer Solutions Center Appeals and Grievances Training Specialist IIAt CCG Business Solutions, LLC, we are seeking a highly skilled and experienced Training Specialist II to join our team. As a key member of our Customer Solutions Center Appeals and Grievances team, you will be responsible for providing ongoing training on the core processing...
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