Clinical Trainer/Sys Admin--South Carolina at Charleston

Job Description

Clinical Trainer System Administrator

Position Summary: The Clinical Trainer System Administrator is responsible for development, coordination and provision of education and training to all associates in the Medical Management Department. Responsibilities also include maintenance and provision of orientation programs for all staff positions, development of Continuing Education Unit (CEU) for professional nurses and case management staff, clinical in-service education offerings including programs provided by the Plans Network Providers/Vendors on services available to members, process improvement and work flow training programs. Assist leadership in the ongoing assessment of educational needs of all Medical Management Department staff.

NOTE: This posiiotn will be geogrpahically located in North Charleston, SC.

Principal Accountabilities:

• Plans, develops and conducts education and training programs for staff necessary to meet the organizations business objectives and regulatory guidelines and to improve skills and professional growth and development.
• Assists with training on utilization of Medical Management software platform and applications utilized by Utilization Management and Case Management staff as requested.
• Maintains current knowledge base with regard to rules, regulations, policies and procedures relating to the implementation of all Medical Management functions: Intake, Prior Authorization, Concurrent Review, Discharge Planning, Alternate Service, DME, Special Needs, Appeals and Case Management.
• Coordinates clinical and process orientation for all new hires. In cooperation with new employees clinical supervisor, supports and assists new associate in completion of job specific orientation
• Maintains the audit process for all new hires in all departments and assists supervisors and managers with staff on a performance action plan and re-educates as necessary.
• Works with appropriate management staff to evaluate the performance of staff during orientation period.
• Works with Clinical Services system vendors and IS to ensure medical management applications function appropriately and that all upgrades, enhancements and implementations are successful.
• Coordinates system configuration changes, including tables, options, rules, and assessments and oversees system testing to make sure systems are working as expected
• Works with various IS and vendor project managers to coordinate creation and successful migration of customizations.
• Sets up, maintains, updates, as needed, provider portal rules and trigger tools. Maintains the integrity of the rules engine
• Assist with training and support of the provider portal users.
  Uses clinical knowledge and criteria expertise to assist with creation and delivery of inter-rater reliability testing and InterQual end user training.
• Assists with the development of departmental workflows.
• Arranges and coordinates guest speakers offering educational programs with the provision of CEUs for professional staff.

Position Qualifications/Requirements:

Education and Training:

• Graduation from an accredited school of nursing/college/university or B.S. degree in information systems.
• Experience:
• Minimal of 3-5 years experience with system oversight and training responsibilities with Medical Management Systems
• Operational understanding and knowledge of the processes of Medical Management including Utilization Review, Prior Authorization, Case Management, and Inter-Rater Reliability
• Strong system knowledge of the following platforms and medical guidelines: MEDecision, Facets, Milliman USA, and InterQual

Licenses, Registrations or Certification:

• RN valid in state of South Carolina, unrestricted.
• Dependable Transportation.
• Valid drivers license with car insurance.
• Travel, local and some distance with overnight stays, as required

Job Requirements

Country: USA, State: South Carolina, City: Charleston, Company: Select Health of South Carolina.