Clinical Trainer

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when theyre supported to live their best lives, and when they feel welcome to bring their whole selves to work. Thats one reason why diversity and inclusion are core to our business.

Join Evolent for the mission. Stay for the culture.

What You’ll Be Doing:

Evolent is looking for a Clinical Trainer to be a key member of our Shared Services Training and Development Team. You will play a crucial role in equipping our staff with the necessary skills and knowledge to effectively handle authorization requests. Your expertise will contribute to conducting engaging and informative training sessions for staff involved in the authorization review process. Ensure trainees understand departmental policies, regulatory requirements, and client contractual agreements.

Collaboration Opportunities:

You’ll collaborate with the training team to update and enhance training materials and keep content relevant, accurate, and aligned with business expectations. You could be asked to assist with special projects related to process improvement or system enhancements and participate in auditing cases to ensure adherence to guidelines.

What Youll Be Doing:

Training staff on the authorization request process.

Provide engaging and informative training sessions.

Detail departmental policies, regulatory requirements, and client contractual agreements.

Update training materials to keep content relevant, accurate, and aligned with business expectations.

Educate on utilizing approved clinical guidelines to authorize services or procedures and when a request does not meet established clinical guidelines for appropriateness and medical necessity, how to submit the request to a physician reviewer.

Educates and supports UM staff with medication requests, laboratory results and documentation of submissions per approved policy guidelines.

Complies with current URAC standards as they relate to this position.

Supports clinical initiatives as identified by the UM department and UMC.

Assists Chief Medical Officer (CMO), Medical Reviewers and the Clinical Specialist in the submission of developed and approved pathways sent to Information Technology.

Complies with HIPAA requirements and all Evolent policies and procedures.

Acts as an interdepartmental liaison between all Evolent offices, departments, and committees.

Provides additional Education support and training monthly and or as needed.

Supports the business needs of training department to support nurse and physician team needs.

Performs other duties as assigned.

The Experience Youll Need (required) :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Possesses effective verbal/written communication skills with the ability to interact with various levels of personnel.

Able to work in a fast-paced environment, demonstrate excellent problem solving, critical thinking, and organizational skills.

Performs multiple tasks efficiently and accurately, have exceptional attention to detail and perform consistent work product validation/QA.

Self-motivated, self-directed, team oriented, and responsible, with a positive attitude and a proactive style. Possesses the ability to operate in a highly variable work environment.

Bachelor’s degree in Nursing or HealthCare related field preferred. Unrestricted Registered Nurse (RN), LPN or LVN license required for the state of employment.

Excellent customer service skills.

Strong computer skills in MS Excel and Word.

Ability to easily navigate through website research.

Finishing Touches (preferred):

2 – 4 years UM experience preferred.

2 – 3 years in an inpatient or outpatient setting highly preferred.

Specialty certification preferred.

Oncology and/or cardiology experience highly preferred.

Learning & Development Experience.

Experience in training or project management.

Skilled using PowerPoint, SharePoint, Excel and other Microsoft Programs.

Ability to support management team with employee training and development.

Ability to identify problems and recommend solutions.

Technical Requirements:

We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact recruiting@evolent.com for further assistance.

The expected base salary/wage range for this position is $. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.

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For more insights about Evolent Health, click on Life At Evolent (https://www.evolent.com/) to learn more!