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Case Management Program Auditor and Trainer
2 months ago
The Case Management Program Auditor and Trainer will oversee and review the performance of Case Managers and Community Care Coordinators to ensure quality and cost-effective member-centered care and adherence to contractual requirements.
Key Responsibilities- Develop and administer a universal training curriculum for new employees and ongoing training to maintain identified core competencies.
- Collaborate with health plan leadership to identify training needs and develop solutions to deficiencies.
- Evaluate the effectiveness of training tools in accordance with CMS requirements.
- Complete monthly audits and communicate results to respective managers.
- Prepare audit findings and communicate to manager.
- Facilitate a response mechanism to individuals/teams for questions/concerns.
- Review and recommend updates to policies and procedures within the Case Management department.
- Stay abreast of product/member/provider issues, legislation, CMS mandates, policy changes, and system changes.
This position requires strong analytical and communication skills, as well as the ability to work collaboratively with cross-functional teams.
About Neighborhood Health Plan of Rhode IslandNeighborhood Health Plan of Rhode Island is a health plan dedicated to providing high-quality, member-centered care to our community.
