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Director of Training & Auditing

Columbus, OH · Healthcare
Director of Training & Auditing – Managed Care
75% Remote, 25% Onsite (Ohio) 
 
*** Work from Home 75%, 25% In-Office in Ohio ***
 
 
Director of Training & Auditing Job Summary: 
 
  • Accountable for training and auditing for all clinical operation teams across the enterprise including development and oversight of content, processes, and requirements
  • Direct staff in the planning, organizing, directing, and monitoring of clinical training and auditing functions, including training, evaluating, and addressing identified performance matters
  • Oversight of the development of curriculum, coordination and facilitation of training to meet mandated requirements
  • Along with measuring performance of training, provide feedback for performance improvement, identify unmet training needs, and develop processes to improve training performance and quality
  • Collaborate with enterprise and market leaders to ensure learning plan initiatives and solutions align to delivering required performance outcomes that support achievement of clinical goals
  • Partner with enterprise training team and enterprise Quality leadership to align program approach and establish collaborative monitoring tools/dashboards to measure success/intended outcomes
  • Partner with market leadership teams to conduct quarterly strategic needs assessments to ensure technical, clinical, and quality learning initiatives are accomplished
  • Develop and implement the clinical audit program including performance, operational, financial, clinical and compliance audit projects
  • Direct audit procedures, including identifying and defining issues, developing criteria, reviewing and analyzing evidence, and documenting processes and procedures
  • Support the development and deployment of quality monitoring strategies, guidelines, and standard operating procedures
  • Design, develop, and deploy quality assurance reporting capabilities providing actionable insights enabling process improvements, training improvements, and performance insight
 
 
Director of Training & Auditing Background:  
  • Registered Nurse (RN) with an unrestricted state license
  • 3+ years healthcare payer experience required, preferably with Medicaid in a managed care environment
  • 5+ years clinical operations, quality, and/or clinical training experience required
  • Requires bachelor’s degree, master’s degree preferred
  • 3+ years leadership experience, including leadership of healthcare staff or managing a healthcare project/process
  • Certified Case Manager (CCM) preferred
  • 5+ curriculum development experience required
  • Expert at directing the utilization of multiple technology to create multimedia presentations and online learning options in curriculum development
  • Demonstrated understanding of technical/business systems operations (i.e. EHR, EMR, claims systems)
  • Knowledge and understanding of e-learning design technology and adult learning strategies
  • Understanding and demonstrated application of Adult Learning Theory in course design and facilitation skills
  • Demonstrated ability to translate business needs into effective learning solutions
  • Experience with data analytics is preferred
  • Extensive knowledge of and skill in applying internal auditing principles and practices, management principles and preferred business practices.
  • Experience in leading/coaching staff in a matrix environment to meet operational objectives and timelines
#ADMIN or #CLINICAL
#CARE1
 
Erik Berg
Executive Search Consultant/Account Manager

CareNational
erik@carenational.com
443.470.8240 (CALL – TEXT – FAX)
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