Utilization Management Systems Trainer

Utilization Management Systems Trainer

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings.

The Utilization Management (UM) Trainer (Technical and Systems Focus) will be responsible for designing, delivering, and evaluating training programs focused on the technical workflows and compliance requirements of the managed care platforms. This position will work directly with the UM team to ensure staff are proficient in the technical aspects of the platform and how these workflows tie to operational and regulatory compliance. The trainer will be instrumental in facilitating the system's efficient use, ensuring proper documentation and data integrity, and supporting compliance within the platform.

Responsibilities may include :

• Training Design and Delivery : Develop and deliver customized training programs on the technical workflows of the managed care platform, with an emphasis on compliance.
• Collaborate with the UM leadership to ensure that training materials are tailored to the needs of the team and align with operational goals and compliance standards.
• Facilitate live training sessions, webinars, and e-learning modules to equip UM staff with the skills to effectively use the system while adhering to compliance standards.
• Compliance and System Proficiency : Ensure that all UM staff are proficient in the technical workflows of the platform, including documentation practices that align with regulatory standards.
• Partner with the delegation management and system level compliance teams to ensure that all workflows are understood in the context of meeting legal and regulatory guidelines.
• Provide guidance on how UM staff can use platform fields and modules to comply with regulations, such as documenting authorization details and clinical data.
• Documentation and Platform Utilization : Train UM staff on the proper use of fields and documentation processes within the managed care platform to ensure that data is captured accurately and complies with regulatory standards.
• Collaborate with systems ops, IT and delegation mgmt / system compliance teams to keep training content aligned with updates and improvements.
• Ongoing Evaluation and Feedback : Track and evaluate the effectiveness of the training programs, with a focus on compliance and system proficiency.
• Offer continuous feedback to UM staff regarding their performance and documentation quality, adjusting training programs based on results.
• Identify gaps in training and work with leadership to address areas where additional support is needed.
• Collaboration and Support : Partner directly with the UM team to tailor the training programs and workflows to the team's specific needs.
• Act as a point of contact for troubleshooting issues, providing technical support and addressing questions related to system usage or compliance.

Minimum Qualifications :

Preferred Qualifications :

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population health care management pathways.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.