Clinical Development and Education Consultant

About the role

The Clinical Development Education Consultant position involves planning, directing, coordinating, executing, and evaluating educational programs to support clinical staff and functions. This role collaborates with clinical leadership, quality, compliance, and human resources to ensure the successful creation and implementation of onboarding and training programs for all clinical new hires, as well as developing and managing continuing education, training, and professional development initiatives.

Responsibilities

• Manages the education and programmatic information necessary to perform job responsibilities in accordance with corporate policy as well as regulatory and accreditation requirements.
• Ensures all clinical staff are in compliance with regulations and requirements through comprehensive training strategies and measuring staff understanding.
• Manages the process for clinical competency evaluation for ongoing and provision of continuing education as it relates to clinical programs and best practice, policies and procedures, as well as competency evaluation for new personnel.
• Plans, organizes, evaluates, and maintains orientation/onboarding process for new clinical employees and communicates progress to leadership, recommending remediation as appropriate and documenting completion of orientation, competencies and mandatory trainings.
• Mentors and assists clinical staff with identification of available continuing education and professional development opportunities and requirements as applicable.
• Provides targeted education in support of regulatory audits, accreditation surveys, and corrective action plans.
• Attends company and departmental meetings and training sessions as required.
• Identifies training needs and develops educational materials based on results of audits, Inter-Rater Reliability Assessments, and quality findings.
• Provides one-on-one and group consultation to address performance gaps, documentation quality, and decision consistency.
• Recommends improvements to processes and educational strategies based on data and best practices.
• Facilitates program (i.e. TruCare) based trainings to clinical staff.

Qualifications

• Strong organizational, problem solving, documentation, and communication skills, with the ability to successfully engage others.
• Approachable, adaptable, and flexible to change and new or unexpected circumstances.
• Highly comfortable with clinical documentation systems.
• Demonstrated effective public speaking and written communication skills.
• Ability to operate a personal computer (PC), including proficiency in Microsoft Office Products.
• Knowledge of developing educational content.
• Experience supporting CMS, NCQA, or state regulatory audits.
• Experience developing educational content.
• Experience in health insurance, or other related healthcare field preferred.

Skills

• Strong organizational, problem solving, documentation, and communication skills, with the ability to successfully engage others.
• Approachable, adaptable, and flexible to change and new or unexpected circumstances.
• Highly comfortable with clinical documentation systems.
• Demonstrated effective public speaking and written communication skills.
• Ability to operate a personal computer (PC), including proficiency in Microsoft Office Products.
• Knowledge of developing educational content.
• Experience supporting CMS, NCQA, or state regulatory audits.
• Experience developing educational content.
• Experience in health insurance, or other related healthcare field preferred.

Requirements

• Minimum of 5 years of Utilization Management experience in a health plan, managed care organization, or similar setting.
• Minimum 5 years’ experience in an acute care setting.
• Minimum of 3 years demonstrated experience in education, training, coaching, or professional development.
• Registered Nurse with active licensure in PA or Enhanced Nurse Licensure Compact (eNLC) multistate licensure in home state.
• Bachelor’s degree in Nursing or higher required; bachelor’s degree in business, education, or a health related field accepted.
• Masters degree preferred.
• InterQual® certification is strongly preferred or willing to obtain when offered.

Benefits

At Capital Blue Cross, we offer a comprehensive benefits package including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.

Pay

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates.

Schedule

Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor. Sedentary work involving significant periods of sitting, talking, listening, typing and performing repetitive motions.