Assess job-specific needs and develop technical training plans with clear business objectives
Select training/instructional methods and procedures appropriate for the situation
Deliver specific training sessions, including using suitable delivery methods such as classroom, online, and webinar
Identify the development needs of others and coach, mentor, or otherwise assist others with improving their knowledge skills
Provide support to the CCV audit team members; assist with orientation of new members as needed
Promote audit accuracy measures by training/educating and mentoring the auditor and providing documented and validated findings
Conduct or arrange for ongoing technical training and personal development classes for staff members
Integrate healthcare auditing principles and use objectivity in the performance of medical audit activities and reviews
Provide feedback on reviews to the Quality Assurance Manager as indicated

Associate or Bachelor's degree in nursing
RN License (active/unrestricted in state of residence)
Case Management Certification (preferred, but not required)
5 to 7+ years of working with InterQual/MCG (Inpatient vs Observation)
Background in Utilization Management and/or Case Management
Critical Care background: ICU, Emergency Room, Cath Lab, Med Surg
5 to 7+ years of working with a broad knowledge of medical claims, billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology
Requires expert level knowledge of Interqual and/or MCG criteria
Strong presentation skills
Independent thinker, logical, strategic, with a high focus and attention to detail
Effective communication and presentation style (written and verbal) with proven ability to positively influence behavior and outcomes
Knowledge of principles and methods for curriculum and training design, teaching and instruction for individuals and groups, and the measurement of training effects
Competent administrative and organizational skills, ability to multitask, set priorities, and meet deadlines
High level of proficiency with all audit technology i.e., R3, CAT, etc.
Proficiency in Word, Access, Excel, PowerPoint and other applications
Excellent written and verbal communication skills

Auditor, Technical Trainer – POS

Key skills