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Department

*Must Be a Colorado Resident*

Job Summary

This position is responsible for developing delivering monitoring and maintaining a variety of clinical training programs for the Health Services Department. The position is further responsible for creating comprehensive auditing tools to ensure standardization and consistency of nurse reviewer clinical decisions compliance to department policies and procedures and compliance to regulatory standards. Team member is responsible for collaborating with health plan leadership to identify training needs outside of core curriculum to promote maximized effectiveness in managing behavioral and medical costs. The Trainer/Auditor will maintain and monitor the delivery and effectiveness of the training program and identify solutions to challenges. This includes maintaining records of training activities and employees progress. Will work with audit team to identify and develop training based on the results of audits and corrective actions. Will work with business partners and IT to develop implement monitor and evaluate workplace performance and training solutions. Responsible for coordinating training from external vendors to meet the needs of the department. This position develops implements and manages learning interventions in support of employee learning and performance related projects. In addition may need to be a resource to assist/advise Supervisors and/or process authorizations as needed.

Essential Functions:

• Develop and administer a universal training curriculum for new Health Services employees as well as ongoing training to maintain identified core competencies 10
• Develop training curriculum based on clinical staff knowledge needs and areas of improvement needed as identified by senior leadership staff request or other business indicators 10
• Designs and develops appropriate and effective instructional materials and content for Medical Management systems (Examples: QNXT Guiding Care MCG JIRA etc. 10
• Coordinate training efforts with various crossfunctional areas within clinical department (Referral Coordinators Inpatient and Outpatient Clinical Teams etc. 10
• Participate in cross functional teams (HPS Claims IT Product Compliance etc. to identify and solve system issues 5
• Develop teaching aids such as training handbooks demonstration models multimedia visual aids computer tutorials and reference works as applicable 10
• Serves as an advocate for learning and change management in project planning meetings and effectively communicate project plans milestones and training strategy on an ongoing basis. Example: System Upgrades 5
• Evaluate effectiveness of training programs including cost and benefit analyses and communicate results to management 10
• Audit team results identify gaps in training and implement improvements in training programs 5
• Prepare audit findings documentation of deficiencies as well as develop final analysis reports for Health Services Department Leadership 5
• Responsible for staying abreast of product/member/provider issues legislation CMS mandates policy changes and system changes so they can be considered for training topics 5
• Collaborates with Health Services leadership to implement and monitor individual CAPs and/or PIPs as necessary. 5
• Assist and advise supervisors as needed. 5
• Process authorization requests as needed. 5

Education:

• Bachelors Degree in Nursing (BSN) required

Work Experience:

• 13 years comprehensive knowledge of Utilization Management in a managed care environment required and
• 13 years experience working with Milliman Care Guidelines (MCG) InterQual and/or other clinical criteria/guidelines required and
• Less than 1 year experience training in a virtual environment desirable
• Less than 1 year clinical training/education and instructional design experience preferably in managed care preferred

Licenses:

• RNRegistered Nurse DORA Department of Regulatory Agencies required

Knowledge Skills and Abilities:

• Strong written and verbal communications.
• Excellent organizational skills and strong attention to detail
• High level of personal accountability and integrity
• Ability to gather analyze data and prepare informative and accurate reports.
• Ability to understand the workflow of multiple components of the company and to assist in the creation and implementation of integrated policies procedures workplans and creative solutions.
• Advanced PC proficiency
• Good working knowledge of regulatory requirements/standards.
• Ability to work with others or independently with minimal supervision

Shift

Work Type

Salary

Benefits

• Outstanding benefits including up to 27 paid days off per year immediate retirement plan employer contribution up to 9.5 and generous medical plans

• Free RTD EcoPass (public transportation)

• Onsite employee fitness center and wellness classes

• Childcare discount programs & exclusive perks on large brands travel and more

• Tuition reimbursement & assistance

• Education & development opportunities including career pathways and coaching

• Professional clinical advancement program & shared governance

• Public Service Loan Forgiveness (PSLF) eligible employer free student loan coaching and assistance navigating the PSLF program

• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

Our Values

• Respect

• Belonging

• Accountability

• Transparency

All job applicants for safetysensitive positions must pass a preemployment drug test once a conditional offer of employment has been made.

Denver Health is an integrated highquality academic health care system considered a model for the nation that includes a Level I Trauma Center a 555bed acute care medical center Denvers 911 emergency medical response system 10 family health centers 19 schoolbased health centers Rocky Mountain Poison & Drug Safety a Public Health Institute an HMO and The Denver Health Foundation.

As Colorados primary and essential safetynet institution Denver Health is a missiondriven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community focusing on hiring and purchasing locally as applicable serving as a pillar for community needs and caring for more than 185000 individuals and 67000 children a year.

Located near downtown Denver Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas talents and contributions reflective of the needs of our community.

Applicants will be considered until the position is filled.