Job Summary
The Instructional Design and Trainer Mid (Clinical Trainer and Operational Support) provides clinical and operational support across the Integrated Health Solutions division. This position develops practical job aids, learning materials, and contract-specific training for clinical staff working in utilization management, case management, and assessment programs. The role supports onboarding, reinforces consistent application of clinical and operational workflows, and helps teams deliver accurate, timely, and member-centered services for Medicaid populations.
Responsibilities
- Develop, update, and maintain job aids, reference guides, process documents, checklists, presentations, and other learning materials for clinical staff.
- Create training content related to utilization management, case management, and assessments, including clinical workflows, documentation standards, systems, contract requirements, and escalation processes.
- Support onboarding and orientation for new clinical staff by coordinating training activities, preparing materials, reinforcing role expectations, and helping new employees apply knowledge in day-to-day operations.
- Deliver or co-facilitate contract-specific training for staff working in utilization management, case management, and assessment programs.
- Partner with operational leaders, clinical subject-matter experts, quality teams, implementation teams, and other stakeholders to identify training needs and ensure materials reflect current policies, workflows, and client requirements.
- Translate complex clinical, regulatory, system, and contract information into clear, practical guidance for clinical staff with varying levels of experience.
- Provide operational support during implementations, workflow changes, system enhancements, new program launches, and other initiatives that affect clinical staff or service delivery.
- Assist with readiness activities, including training plans, schedules, attendance tracking, knowledge checks, competency validation, and follow-up support.
- Review staff questions, workflow concerns, and training feedback to identify opportunities for clarification, process improvement, and additional education.
- Support the development and maintenance of standardized training materials while incorporating state-specific and contract-specific requirements as needed.
- Collaborate with quality and operational teams to reinforce documentation accuracy, clinical decision-making standards, productivity expectations, and compliance requirements.
- Participate in meetings, workgroups, workflow design sessions, system demonstrations, and other activities necessary to maintain current knowledge of assigned programs.
- Use sound clinical judgment and Medicaid program knowledge to identify potential operational risks and escalate issues to the appropriate leader.
- Maintain appropriate confidentiality and comply with all corporate policies, including HIPAA and its Privacy and Security Rules.
- Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.
The list of responsibilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.
Required Qualifications
- Active, unrestricted license (LPN, RN, OR LCSW) in at least one U.S. state; ability to obtain additional licenses as required by business or contract needs.
- Extensive experience working with Medicaid programs and utilization management in a health plan, managed care, provider, government, or vendor environment.
- Demonstrated clinical experience creating, interpreting, or applying utilization management policies, clinical criteria, and contract-specific requirements.
- Experience developing or delivering training, job aids, procedures, or other education for clinical staff.
- Ability to understand and communicate clinical, operational, regulatory, system, and contract requirements accurately.
- Preferred experience in case management and/or clinical assessments.
Preferred Qualifications
- Bachelor's degree in nursing, health care administration, education, or a related field preferred; equivalent education and experience may be considered.
- Strong facilitation, presentation, writing, organization, and problem-solving skills.
- Ability to tailor training and support to different audiences, learning needs, clinical disciplines, and contract requirements.
- Demonstrated ability to create clear, concise, and user-friendly job aids and learning materials.
- Ability to manage multiple priorities, meet deadlines, and independently organize work across multiple initiatives.
- Strong collaboration skills and ability to build effective working relationships with clinical and operational stakeholders.
- Ability to identify gaps, assess operational impact, recommend practical solutions, and escalate risks appropriately.
- Working knowledge of clinical documentation, quality processes, health care systems, and common productivity or workflow tools.
- Ability to maintain a positive, professional, and service-oriented approach when supporting staff and leaders.
Experience in Lieu of Degree
For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree.
Pay Range
USD $67,200.00 - USD $84,000.00 /Yr.