At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. When determining base pay, we take a comprehensive approach that considers your skills, relevant experience, education, certifications, and other critical factors. The pay information provided offers an estimate based on the minimum job qualifications, but it does not encompass all the elements that contribute to your total compensation package.
This is a hybrid role that requires an onsite presence at least 1x/every other month. Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. The Clinical Educator will play a crucial role in enhancing the clinical knowledge and skills of our clinical staff. This person will be responsible for identifying professional development needs, working in conjunction with the organizations Learning & Development team to design and implement training programs for the Clinical department. This role will also be the subject matter expert available during trainings to aid in answering questions, especially those clinical in nature. The Clinical Educator will evaluate existing trainings programs for effectiveness and compliance with all regulations and work with Learning & Development to update trainings as needed. The Clinical Educator will collaborate with various stakeholders, including clinicians, administrators, and internal partners, to identify educational needs and develop innovative learning solutions. Areas of focus for the Clinical Educator will be in Care Management, Utilization Management, Appeals & Grievances, Behavioral Health and Pharmacy. Principal Duties and Responsibilities: Develop and implement A Clinical department-specific onboarding program for new Clinical staff. In conjunction with Learning & Development: • Develop and administer a clinical orientation program for new Clinical staff specific with department learning objectives • Develop and administer department specific orientation tools, plans, and resources for each team (Utilization Management, Care Management, Appeals and Grievances, Pharmacy) • Assist with performance monitoring by supporting the clinical managers in evaluating understanding of policies, procedures, and regulations and providing remediation • Support managers in identifying proficiencies and key areas of improvement periodically during 90-day performance probationary period Develop and implement Clinical specific ongoing learning programs • Develop annual education strategy, including developing and maintaining clinical training schedule with the Learning & Development team • In response toclinical manager requests, design and implement team-based and individual professional development plans, including development of core competencies in select conditions or programs • Participate in the ongoing assessment of learning needs for Clinical department staff • Assist clinical managers in ensuring best practices are put in place consistently across the department as it relates to training and compliance • Monitor changes to key systems and processes and create new or update materials such as job aids) and evaluate trainings needs or updates with Learning & Development team • Provide education and resources to support managers in areas such as care planning activities, documentation, MGB HP benefits, regulations/compliance, utilization management processes Support tools and trainings related to Clinical operations and enhancements • Review workflows and policies (including references) and maintain organized repository • Provide change management support during implementation of new clinical systems and processes • Facilitate training outputs of quality improvement initiatives • Participate in and lead quality improvement initiatives within Clinical Operations • Participate in and lead work groups, as needed Ensure training within the Clinical department is aligned with compliance requirements • Develop understanding of compliance regulations and stay abreast of changes • Proactively adapt guidelines and work with Learning & Development to incorporate into staff training • Support team in making sure that they remain compliant with regulatory requirements • Assist with internal auditing and reporting, and preparation/maintenance of external regulatory audits, as needed Foster collaborative relationships with customers and stakeholders • Develop effective relationships with leaders and staff in the Health Plan • Act in support of clinical initiatives, as appropriate, to ensure the success of others • Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization. Demonstrate organizational norms • Responsible for completing work in a timely manner. Work will meet compliance requirements for Division of Insurance, MassHealth, NCQA, CMS, and departmental standards. Must be flexible to meet the business needs of the department when working on special or high priority projects and when volume of work is temporarily increased. • Hold self and others accountable to meet commitments. • Ensure diversity, equity, and inclusion are integrated as a guiding principle. • Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise. • Perform other duties as assigned with or without accommodation. Qualifications: • Bachelor's degree required • Valid Unrestricted RN license in Massachusetts required • Master's degree in health care, education, or business preferred • Experience with policy development, in-service training, and presentation development required • CCM, Community Health Nursing, Public health background, Care Management, Utilization Management Managed Care, and/or Home Health Nursing experience preferred • InterQual trainer certification preferred • Experience with CCA, QNXT, SharePoint, Visio systems knowledge preferred
