Quality Improvement Nurse Trainer (RN Required)

This is a new position for Health Plan of San Joaquin! As a trainer in our Quality Improvement department you will be responsible for developing and conducting a variety of training and audit programs.

What You Will Be Doing:

• Performs in the capacity of subject matter expert for online clinical systems and clinical work processes for the Quality teams.
• Develops and conducts training programs and supporting materials, including but not limited to job aids and other tools; includes clinical, program and system training.
• Conducts routine and ad-hoc analysis and audits to assess skills and performance against established standards.
• Works with management to identify and implement training opportunities and performance improvement initiatives.
• Leads or actively participates in technical systems rollouts, enhancements, and upgrades, in alignment with key departments, to assure consistent application in clinical departments.
• Participates in the identification and analysis of clinical workflows, recommends solutions, and collaborates in the implementation of workflow efficiency initiatives.
• Maintains appropriate and required data, records, and other operational and regulatory report documentation, including training records.
• Participates in the identification and development of reports to support monitoring of business results.

What You Bring:

• Strong knowledge of health plan operations and interdependencies.
• Strong knowledge of managed care reimbursement processes.
• Strong knowledge of medical management processes and best practices.
• Basic knowledge of NCQA accreditation requirements.
• Strong knowledge of medical management technologies.
• Strong skills in analysis - data identification, integration, validation, manipulation, interpretation and reporting; ability to interpret and determine the impact of complex laws, regulations and other documents.
• Basic knowledge of NCQA requirements related to medical management.
• Strong problem-solving skills.
• Commitment to and ability to facilitate an atmosphere of collaboration and teamwork.
• Strong oral and written communication skills with the ability to communicate professionally effectively to diverse individuals and groups. Includes to ability to effectively explain complex information.
• Ability to interact effectively with individuals both inside and outside of HPSJ, and relate openly and comfortably with diverse groups of people.
• Strong teaching and coaching skills, with the ability to give performance feedback constructively and effectively.

Preferred

What you Have:

Education and Experience

Required

• Associates Degree (A.A) in nursing; and
• At least three years of experience in a managed care or healthcare setting; and
• At least two years in a training role or related experience in a managed care or healthcare setting; or
• Equivalent combination of education and experience.

Preferred

• Experience in business process improvement in a healthcare environment.
• Experience auditing in a healthcare environment.
• Clinical administrative experience in a quality setting.
• Clinical administrative experience in a MediCal or Medicare setting.

License, Certification, Registration

Required

What You Will Get:

HPSJ Perks:

• Competitive salary
• Robust and affordable health/dental/vision with choices in providers
• Generous paid time off
• CalPERS retirement pension program, employer-paid retirements contributions, in addition to a voluntary defined contribution plan
• Two flexible spending accounts (FSAs)
• Employer-Paid Term Life and AD&D Insurance
• Employer-Paid Disability Insurance
• Employer-Paid Life Assistance Program
• Health Advocacy
• Supplemental medical, legal, identity theft protection
• Access to exclusive discount mall
• Education and training reimbursement in addition to employer-paid elective learning courses
• A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do

Our Vision:

Our Mission:

We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.

HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics, or is associated with anyone who has or is perceived to have these characteristics.