Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
- Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
- Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
- Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
- Onsite: daily onsite requirement based on the essential functions of the job
- Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building
Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This remote work opportunity requires residency, and work to be performed, within the State of Arizona.
PURPOSE OF THE JOB
The Clinical Trainer and Auditor is responsible for planning, developing, delivering, coordinating, and evaluating a variety of clinical education programs for health plan clinical operations staff. Training programs include but aren’t limited to that required for NCQA accreditation, New Hire Orientation, Annual Training, Model of Care Training, and CMS and AHCCCS requirements.
QUALIFICATIONS
REQUIRED QUALIFICATIONS
Required Work Experience
- 3 years’ experience in clinical care
- 2 years of work experience in a managed care setting
- Prior experience in NCQA Surveys, CMS Program Audit, and/or AHCCCS Operational Review
Required Education
- Bachelor degree in Nursing
Required License
- Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN within the first 60 days of hire.
Required Certifications
PREFERRED QUALIFICATIONS
Preferred Work Experience
- 5 years’ experience in clinical care
- Physical and behavioral health experience
- 2 years’ experience in a training role
- 5 years’ experience working in a managed care organization
- Training program development
- Knowledge of population health concepts and models
- Knowledge of medical and care management models
Preferred Education
- Master’s Degree in Nursing
Preferred Licenses
Preferred Certifications
ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
- Consults with clinical operations leaders to identify, develop, and respond to training needs and requests Develops curriculum, maintains currency, and revises as appropriate Plan, coordinate, deliver, and evaluate clinical training for clinical operations programs, including:
- Customer service excellence
- Quality and performance metrics
- Ongoing professional grow