Posted in Other 17 days ago.
We enjoy the important work we do every day on behalf of our members.
Job SummaryThe Documentation and Training Specialist Senior is responsible for key departmental functions and initiatives that support the care management programs. This individual will work with numerous internal departments to ensure that cross-functional alignment directs positive outcomes for departmental business and strategic goals. The Documentation and Training Specialist Senior is responsible for the development, implementation, and execution of a robust care management training program; including orientation and annual competency. This position requires solid clinical skills, critical thinking, and care management expertise and is instrumental in understanding the daily workflow of the CM role, including telephonic CM practice to develop workflows, job aids, and policies. . This position requires strong technological and presentation skills.
KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS
* Develop, implement and maintain department training and competency plan. Work in conjunction with team managers and senior care managers to develop and change plan to meet department needs. Responsible for new orientation training plan and guide which will support and foster ongoing mentorship for new staff to be successful in their roles.
* Development and oversight of all internal educational programs, including ascertaining CEU and CCM credits to ensure care management team is knowledgeable in all current CM practice guidelines
* Maintains educational calendar and works with staff preceptors
* Supports accurate documentation and process improvement opportunities
* Supports CMSA standards of Practice
* Acts as resource to all department staff at all levels
* Gather, document and maintain department policies, processes, workflows, and job aids. Responsible to keep database current and accurate for staff and provide education regarding updates and changes.
* Develop key program metrics and capabilities to present to internal and external stakeholders
* Identification and documentation of program scope, timelines, goals, operational and outcome success measures
* Ensure accuracy and timeliness of department reports in conjunction with analytics and leadership team
* Oversight and implementation of all program components and workflows
* Ensures NCQA compliance through tracking mechanisms for audits
* Produces and delivers presentations to internal and external customers
* Develop end to end program content, tools, and resources as determined by department needs. This includes maintaining specific required format for IS team to build in clinical system platform.
* Develop, research, and implement evidence-based assessment content
* Provide evidence-based resources and guides for staff
* Ability to present program content to internal and external customers
* Collaborate and liaise with multiple internal departments to support optimal department performance
* Builds and maintains department disaster plan
* Registered Nurse in Massachusetts required. Bachelor of Science in Nursing or Master's Degree preferred.
* Minimum of 5 years of clinical nursing experience
* Experience in Care Management highly desirable
* Experience in transition/discharge planning highly desirable
* Proficiency in second language desirable
* Ability to address multiple issues of complexity during work day
* Initiative, sound judgement and ability to work under pressure and meet deadlines
* Knowledge and experience in care management
* Proficient in Computer Skills (Microsoft Office)
* Strong written and verbal communication skills
* Ability to work independently and also excellent presentation and training skills
* Excellent teaching skills in individual and group setting including coaching and motivational interviewing skills
* Strong business writing skills
WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS:
* Fast paced office environment handling multiple demands
* Position has ability for remote work as defined by the Manager and Director of Care Management
* Must be able to exercise appropriate judgment when necessary to work and communicate with customers in person or via a telephonic office environment/home office setting.
* Travel required on an as needed basis. Occasional evening, weekend, early morning or extended work day may be required.
CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.
What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!