Utilization Management Trainer, USRN

3 days ago

Manila, National Capital Region, Philippines Optum, a UnitedHealth Group Company Full time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Positions in this function are primarily responsible for the effective delivery of day to day training programs across the organization specifically on the Clinical nursing delivery/work for utilization management and case management. The trainers keeps abreast of various training delivery techniques, relevant clinical knowledge of the US healthcare systems and it relevant protocols, business processes, products and systems.

The trainer will also be exclusively covering clinical deliveries from clinical admin support to clinical day to day delivery required for a registered clinician. This condition will also have the trainer involve to not train outside of specialty of the business family which is clinical delivery. The trainer may also be involved in the design process of training and conceptualization of learning initiatives and solutions. The trainer in this position will cover mainly clinical skills training needs, clinical acumen enhancement and solutions with special focused on business entities serving Utilization Management and Case Management.

Primary Responsibilities:

Assessing learning needs of individuals and teams within clinical programsDeveloping learning goals, objectives, curriculum and measurements that promote desired performance outcomesCreating and delivering instructional content using adult learning principles and strategies with relevant business considerationLeveraging learning technologies and tools for presentation, collaboration and engagementProviding learning and instructional expertise to individuals and teamsFacilitating and managing learning in web-based and/or face-to-face environmentsReviewing evaluative data to make improvements and/or establish new initiatives and business improving solutionsMaintaining updates to curriculum and assessments based on changes and relevant feedback feedbackEstablishing positive working relationships with all levels of staff and managementProviding coaching, guidance and feedback to learnersComply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do soRequired Qualifications:At least a college degree holder (preferably Bachelor of Science in Nursing or other Allied Health courses)Active Philippine Registered Nurse licenseActive non-restricted mainland US Registered Nurse licenseAt least 2 years of Utilization Management/clinical process experience related to Case Management Outreach and/or Utilization Management Review,Clinical Administration and General Clinical Customer ServiceCompetent knowledge of medical terminologies and basic US healthcare processesSpecial consideration on the following delivery:
Client focused call engagement and outreachProvider facing clinical admin workMedicare/Medicaid ExposurePrevious training delivery preferably on a clinical processSpecial considerations on the following clinical are:Skilled nursing facilityHome Health CareLong Term Acute careMaternity NursingCancer and Oncologic NursingMedical and Surgical BackgroundGeneral UM and CM capability Preferred Qualifications:Solid Clinical acumen and awareness of the US healthcare systemSelf-directed worker with a solution-based mindsetSolid listening, verbal, and written communication skillsSuperior interpersonal/customer service skills with Solid phone presenceSolid organizational skills and multitasking abilitiesTechnical aptitude and proficiency with good analytical and decision making skillsHigh aptitude for systems, procedures, process control and development as well as project managementCollaborative and Team OrientedWorkable capability in project management and deliverySolid stakeholder managementKnowledge in ADDIE and relevant training delivery techniques both for instructor led face to face or virtual trainingWorkable capability on digital content creation and use of MS Office 365 apps and tools

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