USRN A&G Trainer

3 days ago

Manila, National Capital Region, Philippines UST Full time

Responsibilities:

Responsible for training A&G clinical staff on processes, policies, and systemsParticipate & lead in the development, implementation, and updating of training manuals to reflect new approaches to training, departmental and/or system process changes and MCG criteria updates as neededOversee and mentor new employees during the initial training programWork closely with the leadership team, QA, and subject matter experts external and internal to assess the learning environment and determine relevant resources for trainingEducate staff in the clinical policies criteria and procedures of MCG as well as an overview of the department, general functions, responsibilities and department relationships with other departmentsDevelop and maintain all training materials and develop training packages with related materials assigned by leadershipParticipate in development, testing and implementation of new programs and systems as assignedShare performance information with operations and training management in an effort to determine next stepsCoordinate administrative activities with the leadership team, including class evaluations, updating files, class registration, scheduling classes, new hire system/software access, personnel information, and attendance management
• Implement ongoing training for experienced nursesDocument outcome of educational processes and share with leadershipTravel may be required (less than 10%) depending on business needThis position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required Qualifications:Registered Nurse with current unrestricted Registered Nurse license in any of the 50 US states requiredMCG certification an advantageContinuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouragedFive (5) years experience in health related fields requiredThree (3) to five (5) years experience with appeals grievances, UM, claims, QA, CMS & MCG guidelines Skills/Knowledge/Abilities (SKA) Required: Effective analytical, verbal, and written communication skillsEffective project management skills to create and execute work plansAbility to work independently and in a team environment Ability to manage multiple tasksProficient in relevant PC applications (Share point, Care Advance, NASCO, 3270, MCMS/AMP, CCDB, IKA and Portico system)Basic knowledge of ICD9/ICD 10 and CPT CodesMEDCO, Member Health Record, VDA (Virtual Desk Top), Care AdvanceKnowledge of local, state and federal regulations (PA250, PA350, DOL, ERISA, HIPPA)Leadership experience Ability to use clinical assessments and interventionsKnowledge of effective communication techniques and theoriesKnowledge of appeals, grievances, claims, UM, quality and/or MCG criteriaMust be willing to act as a "change agent" on behalf of Health Management and positively support the inception of new programs, systems, processes, software, and tools

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