Remote opportunity for residents of Colorado, Illinois, Kentucky, Ohio, Pennsylvania, South Carolina, Texas, Utah, Virginia, Washington, and Wisconsin.
Job Summary
Under general supervision reviews, evaluates and conducts training and monitoring programs for Denver Health Medical Plan (DHMP) to ensure the training and monitoring needs of Managed Care are being fulfilled. Coordinate with an array of teams and assess monitoring needs based on training, regulations and operational needs. In alignment with monitoring, develop standard work, policies and training to meet operational requirements. Analyzes existing training program delivery, content, and aids to measure effectiveness and recommend program changes. Develops and recommends methods and materials in order to train staff. Develops, performs and evaluates new hire and ongoing training of DHMP Staff as needed.
Responsibilities
1. Work with Managed Care teams to identify operational monitoring needs and develop monitoring plans.
2. Work with Managed Care teams to identify operational training needs and develop training plans.
3. Conduct operational monitoring on a regular basis and report out on issues identified.
4. Form findings in operational monitoring identify additional training needs.
5. Documents all identified issues in standard format and provide a regular summary of operation monitoring findings for team leaders.
6. Design and conduct training for new hires and ongoing training based on identified needs.
7. Identify how operational monitoring and training works between teams in addition to the individual teams.
8. Proposes recommendations for continuous improvement within and between Managed Care teams.
9. Maintains knowledge of current regulatory standards, internal policies, and procedures and ensures compliance at all times.
10. Maintains knowledge and information on contract terms and benefit plans for all Plan lines of business.
11. Develops and executes appropriate communication strategies to ensure workflow success.
12. Promotes positive interpersonal relationships with fellow employees, providers, physicians, patients, health plan members and visitors.
13. Consistently displays courteous and respectful verbal and non-verbal communication.
14. Acts as a role model and leader for team relations within Managed Care. Maintains positive behaviors, attitudes, and commitment to day-to-day activities and work efforts.
15. Manages workload in accordance with identified priorities and makes recommendations in modifying deadlines as needed.
16. Prioritizes daily workflow to ensure successful completion of activities and non-project oriented commitments.
17. Identifies and notifies all potential or suspected issues involving fraud, waste, and abuse to the Director of Managed Care Compliance.
18. Ensures confidentiality of patient information by creating and maintaining a secure and trusting environment by not sharing information learned on the job, except when necessary in the performance of the job responsibilities or to improve a patient’s care
19. Other duties as assigned.
Knowledge, Skills and Abilities
1. Proficiency with the Microsoft Office Suite
2. Familiarity with various office equipment
3. Skill in training delivery
4. Skill in training development
5. Advanced research skills
6. Strong communication skills
7. Flexible organization skills
Computers and Technology
1. Proficiency with the Microsoft Office Suite
2. Experience with Data Entry Software
3. Familiarity with various office equipment
Education and Experience
1. Bachelor’s degree required.
2. Two years’ experience in a training, analyst or monitoring position in health care required.
3. Prior experience working between and with multiple operational areas.
Work Type
Full time
Pay Range
$58,900.00 - $85,500.00/yr
All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.
Denver Health is an integrated, efficient, high-quality academic health care system that is considered a model for the nation. The Denver Health system includes the Rocky Mountain Regional Level I Trauma Center, a 525-bed acute care medical center, Denver’s 911 emergency medical response system, 8 family health centers, 15 school-based health centers, the Rocky Mountain Poison and Drug Center, the Denver Public Health Department, an HMO, and The Denver Health Foundation.
As Colorado’s primary safety net institution, Denver Health is a mission-driven organization that has provided more than $3.3 billion in care for the uninsured in the last ten years. Denver Health is a leader in performance and quality improvements and remains financially secure, in part, due to its nationally recognized implementation of lean principles in healthcare. Denver Health is a major resource to the community, serving approximately 185,000 individuals and 67,000 children a year.
Located just south of downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE).
“Denver Health is committed to provide equal treatment and equal employment opportunities to all applicants and employees. Denver Health is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.”
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