Clinical Trainer & Auditor

Location: Phoenix, AZ. Schedule: Mon‑Fri day shift. Job type: Local, on‑site. Contract length: 3 months. Pay rate: $43‑48/hr.

Responsibilities

• Review prior authorizations, audit and fix prior to distribution to members and providers.
• Consult with clinical operations leaders to identify, develop, and respond to training needs and requests.
• Develop curriculum, maintain currency, and revise as appropriate.
• Plan, coordinate, deliver, and evaluate clinical training for clinical operations programs.
• Serve as a resource for staff in areas of clinical practice and professional development, using coaching, mentoring, effective feedback, and motivation support techniques.
• Serve as subject matter expert on policies and procedures, and desktop procedures related to NCQA, CMS, and AHCCCS requirements.
• Utilize a variety of training methodologies, techniques, concepts, learning tools, and practices.
• Provide online and conference call training sessions for remote employees.
• Create and develop training for employees not able to meet or maintain standards of excellence.
• Develop audit tools that meet NCQA, CMS, and AHCCCS requirements.
• Perform case reviews/audits and IRR analysis according to standards.
• Audit staff phone calls and written documentation according to policy.
• Conduct periodic audits of documents such as HRA, ETI, assessments, care plans, and medical necessity documentation to ensure compliance.

Qualifications

• 3 years’ experience in clinical care.
• 2 years of work experience in a managed care setting.
• Prior experience in NCQA surveys, CMS program audit, and/or AHCCCS operational review.
• Prior audit experience.
• RN license OR LCSW, LPC, LISAC, LMFT.

Benefits

• Comprehensive healthcare coverage (medical, dental, and vision plans).
• Supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity).
• 401(k) retirement savings plan.
• Life and disability insurance.
• Employee assistance program.
• Legal support.
• Pet insurance.
• Employee discounts with preferred vendors.