Registered Nurse (RN) - Case Management
EXL
Houston, TX

Registered Nurse, Case Management Clinical Trainer

Company Overview and Culture EXL (NASDAQ: EXLS) is a global analytics and digital solutions company that partners with clients to improve business outcomes and unlock growth. Bringing together deep domain expertise with robust data, powerful analytics, cloud, and AI, we create agile, scalable solutions and execute complex operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media, and retail, among others. Focused on creating value from data for driving faster decision-making and transforming operating models, EXL was founded on the core values of innovation, collaboration, excellence, integrity and respect. Headquartered in New York, our team is over 40,000 strong, with more than 50 offices spanning six continents. For information, visit www.exlservice.com. For the past 20 years, EXL has worked as a strategic partner and won awards in its approach to helping its clients solve business challenges such as digital transformation, improving customer experience, streamlining business operations, taking products to market faster, improving corporate finance, building models to become compliant more quickly with new regulations, turning volumes of data into business opportunities, creating new channels for growth and better adapting to change. The business operates within four business units: Insurance, Health, Analytics, and Emerging businesses. About EXL Health We leverage Human Ingenuity and domain expertise to help clients improve outcomes, optimize revenue and maximize profitability across the healthcare ecosystem. Technology, data and analytics are at the heart of our solutions. We collaborate closely with clients to transform how care is delivered, managed and paid. EXL Health combines deep domain expertise with analytic insights and technology-enabled services to transform how care is delivered, managed, and paid. Leveraging Human Ingenuity, we collaborate with our clients to solve complex problems and enhance their performance with nimble, scalable solutions. With data on more than 260 million lives, we work with hundreds of organizations across the healthcare ecosystem. We help payers improve member care quality and network performance, manage population risk, and optimize revenue while decreasing administrative waste and reducing health claim expenditures. We help Pharmacy Benefit Managers (PBMs) manage member drug benefits and reduce drug spending while maintaining quality. We help provider organizations proactively manage risk, improve outcomes, and optimize network performance. We provide Life Sciences companies with enriched data, insights through advanced analytics and data visualization tools to get the right treatment to the right patient at the right time. As our Case Management Clinical Trainer, you'll be at the heart of developing and delivering exceptional training programs for our case management program. Your role will involve designing and implementing training curriculums, conducting orientation and ongoing education, and ensuring our team stays at the forefront of case management best practices and industry standards. Responsibilities: * Collaborate with department leadership in identifying competencies of clinical and nonclinical staff and assess learning needs of individuals and teams within the case management department. * Develop learning goals, objectives, curriculum, and measurements that promote desired competencies and performance outcomes. * Design and develop training programs, prepare training schedules, and conduct initial and ongoing evaluations of training effectiveness. * Develop behavioral objectives, training methodology, and course materials using instructional design theory and modalities. * Apply alternative training mediums and engagement methods to increase training effectiveness of remote training and accommodate distance learning and various learning styles. * Providing coaching, guidance and feedback to learners. * Develop and provide timely training on updates in policies, procedures, job aides, and other materials to ensure effective implementation and compliance with accreditation standards and regulatory requirements. * Develop and implement annual training on NCQA Case Management accreditation standards. * Design and develop effective learning and evaluation tools which support continued staff development. * Measure and track training effectiveness using a competency evaluation checklist to document the associate demonstrates knowledge and understanding of the content. * Provide feedback to management on individual and group training results. * Maintain project plans for developed courses, including new hire onboarding training for case management for all clinical and non-clinical staff. * Collaborate closely with Case Management Quality Analyst to identify gaps in performance requiring additional training. * Conduct periodic needs assessments to identify knowledge gaps and deliver ongoing refresher training based on staff development needs. * Maintain updates to curriculum and assessments based on changes and relevant feedback from operations and quality leadership. * Establish collaborative working relationships with all levels of staff and management. * Provide input into performance evaluations regarding clinical competence. * Develop training content based on clinical operations procedures using adult learning approach. * Participate in readiness assessments in preparation for accreditation survey submissions. * Maintain CEUs as required by applicable State Board(s) of Nursing and required certifications. Qualifications: Required * Current, unrestricted RN license in the state of residence and ability to obtain multi-state licensure * Bachelor's degree in nursing from an accredited college, university, or school of nursing * 3+ years of case management work experience in a clinical setting (managed care setting preferred) * 3+ years of experience in designing, developing, and delivering in person and virtual (remote) training courses * Ability to obtain Security Clearance required. Current DOD Security Clearance preferred * Must hold United States citizenship status Preferred * Case management certification highly desirable (CCM preferred) * Experience working in an NCQA accredited Case Management program highly desirable * Knowledge and application of adult learning principles in designing and delivering training * Knowledge with ADDIE training framework (analysis, design, development, implementation, and evaluation) and relevant training delivery techniques for instructor led virtual training * Strong and highly effective communication skills (verbal, written, listening, interpersonal) * Knowledge of case management industry best-practices, patient-centered care concepts, current professional standards of case management, and accreditation standards * Experience with or strong working knowledge of NCQA Case Management accreditation standards * Ability to inspire and actively engage learners with outstanding presentation skills * Knowledge of all components of the case management process including outreach, enrollment, assessment, care planning, monitoring and evaluation, facilitation, and advocacy * Proficient in Microsoft Office product suite (Word, Excel, PowerPoint, Outlook, Teams and shared folders) * Self-directed and detail-oriented with solid organizational skills and collaborative solution-based mindset * Ability to work effectively in a cross-functional team environment and adapt to changing program or organizational priorities * Ability to manage multiple simultaneous work demands remotely in an effective and professional manner; ability to reset priorities to meet deadlines * Knowledge of payor issues, contract limitations, provider network issues, and case management initiatives What We Offer: * EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions. * From your very first day, you get an opportunity to work closely with highly experienced, world class Healthcare consultants. * You can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills - key aspects for personal and professional growth. * We provide guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level professional as advisors. * Sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond. * EEO/Minorities/Females/Vets/Disabilities To view our total rewards offered click here -> https://www.exlservice.com/us-careers-and-benefits Base Salary Range Disclaimer: The base salary range represents the low and high end of the EXL base salary range for this position. Actual salaries will vary depending on factors including but not limited to: location and experience. The base salary range listed is just one component of EXL's total compensation package for employees. Other rewards may include bonuses, as well as a Paid Time Off policy, and many region specific benefits. Please also note that the data shared through the job application will be stored and processed by EXL in accordance with the EXL Privacy Policy. Application & Interview Impersonation Warning - Purposely impersonating another individual when applying and / or participating in an interview in order to obtain employment with EXL Service Holdings, Inc. (the "Company") for yourself or for the other individual is a crime. We have implemented measures to deter and to uncover such unlawful conduct. If the Company identifies such fraudulent conduct, it will result in, as applicable, the application being rejected, an offer (if made) being rescinded, or termination of employment as well as possible legal action against the impersonator(s). EXL may use artificial intelligence to create insights on how your candidate information matches the requirements of the job for which you applied. While AI may be used in the recruiting process, all final decisions in the recruiting and hiring process will be taken by the recruiting and hiring teams after considering a candidate's full profile. As a candidate, you can choose to opt out of this artificial intelligence screening process. Your decision to opt out will not negatively impact your opportunity for employment with EXL. Other details * Pay Type Salary * Employment Indicator Regular * Min Hiring Rate $80,000.00 * Max Hiring Rate $100,000.00 * Travel Required Yes * Travel % 25 * Telecommute % 100 * Required Education Bachelor's Degree Apply Now * Atlanta, GA, USA * Baltimore, MD, USA * Boise, ID, USA * Bozeman, MT, USA * Cedar Rapids, IA, USA * Charlotte, NC, USA * Chicago, IL, USA * Cincinnati, OH, USA * Dallas, TX, USA * Houston, TX, USA * Jacksonville, FL, USA * Kansas City, MO, USA * Phoenix, AZ, USA * Pittsburgh, PA, USA * Tulsa, OK, USA * Virtual