Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health Hospitals MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. Position Overview The Clinical Systems Trainer is responsible for training medical management staff in the correct and effective use of Guiding Care for utilization and care management activities across a variety of different departments/teams. At the conclusion of training, they also assess staff ability to begin their specific role in the Division. As new initiatives and functionalities arise, they work jointly with other Medical Management leadership to identify training opportunities and implement strategies to ensure ongoing training needs are met They are responsible for full onboarding and orientation of new clinical employees; they also lead the ongoing training of clinical staff. They develop training and reference materials to ensure staff have the tools needed to streamline operational workflows and overall meet regulatory compliance. They support audit activities as requested. This position works collaboratively with senior leaders across the various departments conducting care management and utilization management to ensure that there is an effort to continuously improve processes with a goal of creating highly efficient and effective care management processes. Job Description Conducts onboarding training sessions for newly hired clinical staff in utilization and care management workflows. Develops and maintains job aids to support each department’s core workflows. Conducts remediation training for identified deviation by individuals and/or teams from policies, procedures, and processes. Conducts ongoing training refresher sessions for clinical staff. Develops evaluation of staff training and provides feedback to respective managers. Responsible for departmental reporting of aggregate training activities Track all activities which can be used as support documentation for CMS or DOH audits. Functions as liaison between medical department and IT to report, document and assist in analysis of IT system issues. Identifies training opportunities and implements strategies to ensure ongoing training needs are met. Assist in internal and external audits as requested. Implements strategies to ensure staff comply with internal or external plan of corrections. Performs all other duties as required, requested or assigned. Minimum Qualifications Bachelor’s Degree in Nursing (BSN); or Master’s Degree in Social Work (MSW); or Diploma from foreign medical school; and A minimum of two years’ clinical experience in an acute care setting Experience using InterQual Guidelines required Strong knowledge of NYSDOH and CMS regulatory guidelines Knowledge of the principals surrounding Utilization Management Standard of Practice Knowledge of organizational and departmental policies, procedures, and processes Ability to work in a fast-paced environment Computer literacy and excellent written and oral communication skills required Licensure and/or Certification Required Registered Nurse with current New York State Nursing license required if candidate holds a Bachelor’s Degree in Nursing (BSN) Licensed Social Worker with current New York State Social Work license required if candidate holds a Master’s Degree in Social Work (MSW) Professional Competencies Integrity and Trust Customer Focus Excellent communication, written and analytical skills Knowledge of computer systems