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Clinical Trainer & Quality Assurance Specialist- RN

at Martin's Point Health Care in Portland, Maine, United States

Job Description

Join Martin’s Point Health Care – an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of “people caring for people,” Martin’s Point employees are on a mission to transform our health care system while creating a healthier community. Martin’s Point employees enjoy an organizational culture of trust and respect, where our values – taking care of ourselves and others, continuous learning, helping each other, and having fun – are brought to life every day. Join us and find out for yourself why Martin’s Point has been certified as a “Great Place to Work” since 2015.

Position Summary Clinical Trainer and Quality Assurance Specialist serves as a subject matter expert to ensure DS system clinical staff (MA, LPN, RN) are effectively onboarded and maintain current evidence based clinical competencies necessary for compliance with NCQA, State/Federal and other applicable regulations. This role has an expert understanding of clinical quality and clinical quality improvement and the ability to relay and incorporate same into job function training and coaching. The Clinical Trainer & Quality Assurance Specialist partners with DS leadership to ensure activities meet and exceed Martin’s Point performance benchmarks for compliance, while improving quality, optimizing cost, and improving patient experience. This position serves as a point of contact for clinical risk incident reporting and performance monitoring efforts and is accountable for DS clinical training and auditing in coordination with DS training specialist. This role will be a champion of clinical process improvement opportunities and demonstrate skills and techniques that support applicable training in adherence to standards, workflows, policies and regulatory requirements. Job Description

Key Outcomes:

Working Knowledge:

+ Maintains working knowledge of CMS, NCQA, State/Federal regulations and contractual obligations that affect DS clinical activities and departmental processes through collaboration with Compliance.

+ Maintains exemplary knowledge of necessary clinical competencies assuring all training and training materials are up to date with most current evidence-based standards and regulatory requirements.

+ Participates in analysis and strategic prioritization of clinical quality opportunities for improvement.

+ Serves as clinical integration department representative in focus groups and other strategic interdepartmental initiatives as appropriate.

Policies/Procedures:

+ Ongoing development, review and/or edit of impacted standard work process in collaboration with DS leadership as updates are obtained from regulatory entities or through process improvement efforts.

+ Works with internal staff and resources to coordinate necessary staff trainings on updates to clinical policies and procedures

Training:

+ Accountable for creation, improvements, maintenance, and scheduling of training which includes but is not limited to: clinical onboarding, standards, workflows, policies and regulatory changes and updates.

+ Point person to schedule clinical content trainings from external sources and apply for CCMs/CEUs (if appropriate).

+ Develops an auditing program and regularly audits the clinical competencies and application of standards.

+ Responsible for collaborating with HMD leadership to organize orientation for new staff – design and evaluate training materials, develop methods, tools, curricula in support of DS new hire clinical training.

Education/Experience:

+ 5+ years of relevant experience in Health Care

+ RN required (BSN preferred)

+ Prefer experience or certification in principles of adult education

+ Experienced in creation of presentation materials including but not limited to use of PowerPoint (required)

Skills/Knowledge/Competencies (Behaviors):

+ Demonstrated ability to manage, organize and prioritize work load and multiple competing demands in a timely accurate manner and ability to function independently.

+ Knowledge of industry standards and innovative approaches to Disease Management, Complex Case Management and Population Health for ensuring high quality collaborative care, effective medical costs and service

+ Knowledge of compliance and regulatory requirements for member and provider care and service, including CMS/ Medicare Advantage, NCQA.

+ Demonstrated analytical knowledge and ability to assess performance against metrics.

+ Demonstrated interpersonal, communications, operational, team building, and quality improvement skills.

+ Excellent interpersonal, verbal and written communication skills

+ Critical thinking: can identify root causes and implement creative solutions

+ Computer proficiency in Microsoft Office products including Word, Excel, and Outlook

+ Ability to demonstrate and support MPHC Core Competencies

We are an equal opportunity/affirmative action employer.

Do you have a question about careers at Martin’s Point Health Care? Contact us at: jobinquiries@martinspoint.org Martin’s Point Health Care is a progressive, not-for-profit organization providing care and coverage to the people of Maine and beyond. The organization operates six primary care health care centers in Maine and New Hampshire, accepting most major insurance plans. Martin’s Point also administers two health plans: Generations Advantage (Medicare Advantage plans available throughout Maine and New Hampshire), and the US Family Health Plan (TRICARE Prime® plan for active-duty and retired military families in northern New England, upstate New York, and western Pennsylvania). For more information, visit https://careers.martinspoint.org .
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Job Posting: JC255434076

Posted On: Feb 17, 2024

Updated On: May 26, 2024

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