Care Management Clinical Trainer - Remote
$86,926–$107,379 year
On-sitePortland, Maine, United States
Job Summary
Design and deliver comprehensive hybrid training programs for Case Management staff, covering both live clinical instruction and e-learning development. Collaborate with leadership to map, optimize, and manage departmental clinical workflows while incorporating NCQA, CMS, and DHA regulatory requirements into all materials. Author and maintain clear job aids, standard operating procedures, and the department SharePoint site to ensure easy access to training assets. Conduct post-training audits to identify knowledge gaps and implement remedial coaching, ensuring activities meet performance benchmarks for compliance, quality, and cost optimization.
Required Qualifications
- Bachelor's Degree in Health Science, Nursing or related field
- Minimum 5 years of clinical case management experience within a managed care organization or health insurer with Medicare Advantage
- Combined experience facilitating live, virtual, and hybrid classrooms, specifically within a corporate healthcare or managed care setting
- Demonstrated experience with NCQA case management accreditation standards, audit preparations, and HEDIS quality metrics
- Competence with computers and business applications; Microsoft Excel, Visio, Word, PowerPoint, Outlook, Access
- Excellent communication and presentation skills, oral and written
- Strong organizational skills including the ability to work independently and prioritize work
- Proven background in adult learning principles and instructional design
- Proven track record of building comprehensive training curriculums from scratch, translating complex medical workflows into digestible learning paths
Desired Qualifications
- Master's degree in Nursing (MSN), Healthcare Administration (MHA), or Public Health (MPH)
- Certified Case Manager (CCM) or American Case Management Association (ACMA) certification
- TRICARE experience
- Experience building QA audit tools, analyzing performance metrics, and creating remediation plans
- Proficiency in health IT systems, including specialized Case Management platforms (e.g., TruCare, Salesforce Health Cloud)
- Electronic Health Records (EHRs), and clinical data analytics reporting tools
- Proficiency in SharePoint administration (permissions, site design)
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