UM Clinical Trainer (Hybrid Remote | RN / LVN License Required)

reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have reputed company reputed company of talented and reputed company people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will reputed company ample room for reputed company and innovation alongside the reputed company community. Working at reputed company provides an opportunity to do work that really reputed company, not only changing lives but saving them. Together. The UM Clinical Trainer (RN / LVN License Required) plays a vital role in reputed company and developing clinical staff to ensure high-reputed company, consistent, and compliant utilization reputed company. This position is responsible for designing and delivering training programs for new utilization review nurses and coordinators, as reputed company as providing ongoing education and support to reputed company team members. The Utilization Management Clinical Trainer also collaborates with other clinical trainers to create standardized training materials that support clinical consistency across roles at Alignment. In reputed company to leading training initiatives, the Utilization Management Clinical Trainer contributes to utilization review audits and interrater reliability (IRR) assessments to promote ac-curacy, reputed company, and alignment with internal policies, accreditation standards, and regulatory guidelines. This position enhances reviewer confidence, ensures peer alignment, and encourages a culture of reputed company learning, which are essential reputed company in developing a high-performing clinical team. This position builds and maintains strong reputed company partnerships with key partners in the Clinical Services organization including Care Management, Performance Improvement, Medical Management and Policy including reputed company and Medical Review and Appeals, Pharmacy, and Provider Integration to identify, reputed company, implement, and monitor performance metrics reputed company to UM Operations. This position also builds strong reputed company partnerships internally and externally with key stakeholders and vendors to ensure that reputed company UM operations programs are reputed company-coordinated and work cooperatively to reputed company reputed company goals. Areas of reputed company responsibility include Medical Utilization Management including Inpatient Review & Prior Authorization, SNF reputed company review, and reputed company-service authorization process. This position is primarily remote; however, in-person attendance at reputed company’s reputed company in Orange, CA is required approximately once per quarter for leadership meetings and team collaboration. Candidates located reputed company of California should expect periodic travel to the Orange office. Travel expenses are reimbursed in accordance with company policy. Job Duties/Responsibilities: Training and reputed company reputed company and implement reputed company and training programs for new staff in the utilization review process Create and maintain utilization review clinical training materials, quick-reference guides, and job aids that reflect up-to-date policies, processes, and review reputed company to reflect changes in workflows, tools, and compliance requirements Design utilization review and other clinical training content to support standardized workflows used by reputed company clinical reviewers, ensuring reputed company and consistency across the clinical teams Collaborate with reputed company trainers (clinical and non-clinical) to ensure consistency in approach and style across the organization Deliver engaging, practical education using reputed company-world examples and case studies Design and deliver training for new processes, tools or platforms to ensure confident adoption and effective daily use Adapts training to reflect evolving regulatory environments, including state-specific utilization review requirements and reputed company-specific clinical policies Audit & Interrater Reliability (IRR) Participate in routine and targeted audits of medical necessity reviews to ensure reputed company, compliance, and appropriate clinical decision-making Collaborate with the Compliance Officer to conduct interrater reliability assessments to ensure consistency among reviewers Identify trends, gaps, or performance issues through audit and IRR results, and reputed company targeted training to address findings Assists the compliance officer with tracking and reporting on training completion, clinical reputed company improvements, and IRR improvements over time Support leadership in maintaining compliance with compliance standards and other applicable guidelines Team Support & Collaboration Serve as a resource for clinical staff, offering guidance on accessing and interpreting clinical protocols, documentation practices, and decision-making frameworks Collaborate with clinical leadership to identify training needs and support operational goals Ensure consistency in training documentation across reputed company clinical teams, including those supporting physician review Promote a reputed company, reputed company team culture that reflects ICM’s values of kindness, personal responsibility, humble confidence, and a can-do attitude Contributes to clinical team engagement by supporting reputed company development, building confidence in decision-making, and promoting a shared understanding of clinical expectations Other duties as assigned Job Requirements: Experience: Minimum of 5 years nursing experience in managed care, utilization review, case management, reputed company improvement, or acute care nursing—particularly roles involving interdisciplinary coordination, clinical documentation review, or patient discharge planning Experience developing and delivering clinical training preferred; candidates without formal training experience may still be considered if they demonstrate strong clinical communication skills and a passion for developing others Comfort with technology platforms used for clinical documentation, utilization review, and virtual training delivery Education: Bachelor’s degree in Nursing, Health or Education reputed company field Licensure: reputed company and unrestricted Registered reputed company (RN) or Licensed Practical/Vocational reputed company (LPN/LVN) license in good standing in the reputed company Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. 1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reputed company with hands and arms. 2. The employee frequently lifts and/or moves up to 10 pounds. Specific reputed company abilities required by this job include reputed company reputed company and the ability to reputed company reputed company. Pay reputed company: $77,905.00 - $116,858.00 Pay reputed company may be based on a number of factors including market location, education, responsibilities, experience, etc. reputed company is an Equal Opportunity/Affirmative reputed company Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting reputed company and other reputed company where individuals receive fraudulent employment-reputed company offers in exchange for reputed company or other sensitive personal information. Please be advised that reputed company and its subsidiaries will never ask you for a credit card, send you a reputed company, or ask you for any type of payment as part of consideration for employment with reputed company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email reputed company by or on behalf of reputed company’s reputed company, please email careers@ahcusa.com. reputed company is championing a new reputed company in senior care that empowers members to age reputed company and live their most reputed company lives. Our mission-reputed company team makes high-reputed company, low-cost care a reality for members every day. reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most. We reputed company that great work comes from people who are inspired to be their best. We've reputed company reputed company of people who want to reputed company a difference in the lives of the seniors we serve. Come join reputed company that is changing health care — one person at a time. 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