Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY

The Learning & Development Training Specialist - Clinician is responsible for collaborating with various departments throughout the organization to identify and implement training related to STAR+PLUS.  In this role the clinical trainer will facilitate required components of Service Coordination training, ensure appropriate application of policies and procedures are imbedded into training resources.  The clinical trainer will serve as a subject matter expert as needed to develop new trainings and/or revise existing content as business needs evolve. It is the responsibility of the clinical trainer to collaborate with applicable departments to map out training plans and schedules, to develop targeted and role-specific training, and conduct skills assessments. The clinical trainer will complete requested and/or identified opportunities for reskilling/upskilling to address any identified gaps.

As a clinical member of the Learning & Development team, you will act as a learning delivery and/or program/project management office (PMO) manager. This will promote effective and leading-edge programs that align with the Learning & Development strategy to achieve desired business outcomes. The clinical trainer is responsible for the direction, coordination, implementation, and completion of projects to achieve business goals. Develop and execute an optimum delivery and/or project management strategy through collaboration with the Learning & Development leaders, Talent Attraction department, and other business leaders, as applicable.


JOB SPECIFICATIONS 

  • Collaborates with Medical Affairs leadership and subject matter experts to develop a strategic plan for STAR+PLUS Service Coordination training.  This position is responsible for developing a robust training plan that meets contractual guidelines as indicated by federal and state regulators.
  • Collaborate with Medical Affairs leadership to ensure required regulatory test are administered.  Analyze test/audit finding related to assessments, documentation, authorizations, and other Service Coordination duties to identify trends impacting best practices within the organization.
  • Regularly evaluate training effectiveness through assessments, feedback, and performance metrics.
  • Provide ongoing support to program staff, offering guidance and resources for continuous learning. Facilitate in-person and virtual training sessions, incorporating interactive elements to enhance participant engagement using current technology.
  • Collaborate with other members of Learning and Development team to maximize new and existing employees understand the life cycle of the STAR+PLUS member throughout each department and establish/update role-specific training as needed. 
  • Other duties as assigned.


QUALIFICATIONS:

  • Education/Specialized Training/Licensure: RN, RUG Certification required.
  • BSN, Person Centered Training Instructor preferred.
  • Work Experience (Years and Area): At least 3-5 years of experience in a managed care health plan as a service coordinator and at least 3-5 years of experience training/precepting/coaching in STAR+PLUS Service Coordination.
  • Experience in Auditing, Utilization Management, Level 1 Service Coordination, Experience in clinical program development.
  • Software Proficiencies: Microsoft (Outlook, Word, PowerPoint, Excel
  • Articulate, Canva, Rise 360, Camtasia

Application Instructions

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