Medical Management
Tulsa, OK, United States
Job Description
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JOB SUMMARY:
Responsible for developing, implementing, monitoring, and evaluating on-going training programs for Medical Management. Assist Medical Management Supervisor with training clinical staff. Identify training opportunities through the quality audit review process and incorporating training in daily stand up, team and monthly staff meetings. Perform quality review on all operational data entry on clinical personnel and select data criteria for Medical management as it relates to regulatory requirements.
KEY RESPONSIBILITIES:
Responsible for developing, implementing, monitoring, and evaluating on-going training programs for Medical Management. Assist Medical Management Supervisor with training clinical staff. Identify training opportunities through the quality audit review process and incorporating training in daily stand up, team and monthly staff meetings. Perform quality review on all operational data entry on clinical personnel and select data criteria for Medical management as it relates to regulatory requirements.
KEY RESPONSIBILITIES:
- Establish training needs for data entry errors identified during the quality review audit process.
- Oversee, train and mentor new employees during training program.
- Monitors and audits mechanisms and controls to ensure appropriate data entry of authorizations, accurate and timely turn around, and accurate authorization production in accordance with established departmental policy and procedures and related training opportunities.
- Plans, organizes, develops, and implements a comprehensive training program to provide staff with current techniques and information relative to their assignments and updates as appropriate.
- Establish training needs for data entry errors identified during the quality review audit process.
- Ability to assess situation, consider alternatives and choose the appropriate course of action.
- Ability to reason logically and to use good judgment when interpreting materials or situations.
- Knowledge of managed care and associated group benefit plans.
- Proficient in Microsoft applications.
- Successful completion of Health Care Sanctions background check.
- Ability to organize time effectively and set priorities.
- Possess strong oral and written communication skills.
- CCM, Certified Internal Auditor (CIA) or Certified Healthcare Compliance (CHC) or related certification preferred.
- Graduation from accredited School of Nursing.
- Current, active, unrestrictive license to practice as Registered Nurse (RN) in the State of Oklahoma.
- At least three years of clinical nursing experience in an acute care setting.
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Job Detail
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Job IdJD4383907
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job LocationTulsa, OK, United States
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EducationNot mentioned