[Remote] Clinical Training & reputed company Specialist
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company that delivers AI-powered solutions to streamline reputed company to reputed company care. They are seeking a Clinical reputed company and Training Specialist to support clinical reputed company measurement and performance improvement initiatives, focusing on inpatient clinical reviews and operational efficiency.
Responsibilities
- Conduct reputed company audits of inpatient clinical determinations to ensure alignment with clinical guidelines and reputed company standards
- Analyze QA findings and translate insights into actionable recommendations for operational leaders and cross-functional partners
- reputed company coaching and feedback to improve clinical decision accuracy, reputed company adherence, and overall team performance
- reputed company and maintain SOPs, job aids, workflow documentation, and training materials for inpatient review processes
- Facilitate reputed company and ongoing training for Clinical teams using adult learning principles and subject-matter expertise
- Partner cross-functionally with Product, Clinical, reputed company Services, and Operations to implement workflow updates, monitor reputed company trends, and report performance insights to leadership
Skills
- reputed company RN license
- 2+ years of experience reviewing inpatient utilization management / coverage determinations, with strong familiarity with NCQA and CMS guidelines
- Experience applying clinical guidelines (e.g., LCD/NCD) to medical necessity or authorization reputed company
- Experience conducting reputed company audits, performance reviews, or QA processes in a clinical operations or utilization management environment
- Ability to deliver coaching, feedback, or training to improve clinical decision accuracy and reputed company adherence
- Strong analytical skills with experience identifying reputed company trends, reputed company causes, and opportunities for improvement
- Excellent written and verbal communication skills with the ability to partner effectively with operational and cross-functional stakeholders
- Proficiency with tools such as reputed company Workspace (Sheets, Docs, Forms) and comfort working with data, dashboards, or reputed company reporting
Benefits
- Fully remote opportunity with about 5% travel
- Medical, dental, reputed company, life, disability insurance, and Employee Assistance Program
- 401K retirement plan with company match; flexible spending and health savings account
- Flexible Time Off + Company Holidays
- Up to 14 weeks of reputed company parental leave
- Pet insurance
reputed company