Clinical Systems Trainer - RN

CareOregon is a nonprofit, mission-driven health plan, focused on providing care to low-income Oregonians. The CareOregon family includes Columbia Pacific CCO, Jackson Care Connect, Housecall Providers and our work as part of Health Share of Oregon. We also support recruitment for the Oregon Health and Education Collaborative.

The Clinical Systems Trainer is responsible for training staff in the correct and effective use of decision tools used for utilization management activities and assess staff readiness to begin their specific role in the Division at the conclusion of training. As new initiatives and functionalities arise, they work jointly with Clinical Operations leadership to identify training opportunities and implement strategies to ensure ongoing training needs are met. They are responsible for onboarding and orientation of new clinical employees to clinical guideline tools (InterQual); they author guidelines from regulatory requirements or customize from nationally recognized clinical content or organizational criteria to meet CareOregon’s needs. They lead the ongoing training of clinical staff as new guidelines are developed. They develop training and reference materials to ensure staff have the tools needed to streamline operational workflows and overall meet regulatory compliance. They support audit activities as requested.

Conduct onboarding training sessions for newly hired clinical staff in utilization management workflows. Develop and maintain job aids to support core workflows. Facilitate remediation training for identified deviation by individuals and/or teams from policies, procedures, and processes. Lead ongoing training refresher sessions for clinical staff. Build evaluation of staff training and provides feedback to respective managers. Responsible for departmental reporting of aggregate training activities. Track all activities which can be used as support documentation for CMS or OHA audits. Identifies training opportunities and implements strategies to ensure ongoing training needs are met. Assist in internal and external audits as requested. Implements strategies to ensure staff comply with internal or external plan of corrections. Develop, review, and update clinical content, ensuring accuracy and relevance. Ensure all content complies with current clinical standards and regulations. Maintain up-to-date knowledge of clinical practices and Medicare and Medicaid guidelines. Assist in the development of training materials and educational resources. Participate in quality improvement initiatives and projects. Design, develop, and update clinical content through the review and understanding of information gathered from regulatory and organizational requirements. Collect and incorporate feedback from internal customers to ensure clinical accuracy and usability. Perform Quality Assurance testing of clinical content and create and maintain clinical documentation. Serve as a clinical resource for both internal customers, including training of new content both created and as part of the product. Collaborate with Medical Directors and Clinical Operations leadership team for organizational criteria. Participate in developing project plans, monitoring tasks and ensuring on-time delivery of clinical content. Organizational Responsibilities: Perform work in alignment with the organization’s mission, vision and values. Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals. Strive to meet annual business goals in support of the organization’s strategic goals. Adhere to the organization’s policies, procedures and other relevant compliance needs. Perform other duties as needed.