MAJOR RESPONSIBILITIES
Conducts training for Clinical Review staff pertaining to Utilization Review process, clinical rule rets, client/module/modality-specific workflows, and software enhancements
Partners with Workforce Planning to develop training schedules conducive to achieving desired program specific outcomes
Proactively identifies targeted improvement opportunities amongst new hires
Partners with Human Resources and Clinical Operations leaders to highlight possible concerns amongst new hire staff
Conducts focused training to ensure that all Clinical Review staff members are properly educated on HealthHelp policies and clinical processes
Reviews monthly quality audit findings and conducts one-on-one coaching with Clinical Review staff to assist with resolving issues related to education and adherence to process and/or client-specific directives
Leverages tools and methodologies to assess the effectiveness of educational content and delivery
Advises Clinical Review management of opportunities for individual performance improvement via the Domestic Nurse Audit Tally
Reviews the Daily Nurse Management Reports from the Quality Department to identify training opportunities
Serves as first line of contact for Clinical Review staff to answer questions/provide clarification related to criteria, policy, and process
Partners with Products to develop training material designed to promote process efficiency and desired program-specific outcomes
Recognizes and informs management of process/performance gaps
Adheres to all regulatory requirements and complies with HealthHelp policies and procedures
Upholds professional standards and performs all work in a manner respectful of others
Provides a high level of service and support to both internal and external clients
Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy
Performs other duties as assigned to meet business needs
Required Skills
Required Experience
WORK ENVIRONMENT
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.
TRAVEL
Dependent on business needs
OTHER DUTIES
Please note that this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
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HealthHelp provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state, and local laws.