Senior Clinical Trainer & Auditor (Registered Nurse)

Fidelis Care - New York is proud to provide quality, affordable health coverage for more than 2 million members, at all stages of life. At Fidelis Care - New York, we’re dedicated to serving residents of New York State who need quality, affordable health coverage. Grassroots outreach - from inner-city neighborhoods to the most rural towns - is central to our mission. From provider offices, to schools, churches, food pantries, and community agencies, Fidelis Care - New York works closely with hundreds of partners to reach local residents in need and to be a resource in our community. Fidelis Care - New York provides coverage through Child Health Plus, Essential Plan, Medicaid, Health and Recovery Plan, Qualified Health Plans, Managed Long Term Care, and Medicare and Dual Advantage Plans.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. This is a fully remote position with required bi‑annual travel to New York. Candidates must have the flexibility to work a schedule of their choosing within the hours of 600 a.m. to 600 p.m. Eastern Time.*** Position Purpose Develop, conduct, administer and analyze clinical training programs, conduct audits of clinical systems entry and/or processes, and assist in development of audit tools

Develop and conduct clinical education courses, including case management education and training for new employees Develop and maintain complex audit processes and audit tools related to authorizations, appeals, quality, case management, inter-rater reliability and data entry Audit established guidelines (e.g. Interqual) for medical necessity Analyze training needs and identify, select or develop appropriate training programs including training aids and materials Audit staff in accordance with established auditing processes, work with staff to identify and resolve errors in data and reporting, and present findings and recommendations for improvement to management Train audit staff in the use of audit tools and identification of patterns or trends that require additional training or corrective action Evaluate effectiveness of training programs including cost/benefit analyses Research, analyze, and recommend internal/external training programs Maintain records of training activities and employee progress Assist with revisions to Policy and Procedure and/or work process development Participate in Quality and Advisory committees) or provider education meetings Travel may be required