Salary Range: $60,778.00 (Min.) - $71,398.00 (Mid.) - $91,166.00 (Max.)
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.
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Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.Job Summary
The Authorization Technician (AT)Training Specialist II works under the guidance of a departmental Manager and is responsible for conducting functional and technical training across all Utilization Management Departments in alignment with existing or updated policies and procedures. This position will coordinate and provide training with the onboarding of AT new hires. This position is responsible for ongoing training, education, and remediation for existing staff. The position must be a subject matter expert in the authorization technician process and standards of practice. This position will also assist with operational, reporting, and accrediting requirements for all lines of business.
This position will conduct periodic educational needs assessments for AT staff across all lines of business to assess needs for additional training, and development of new tools or resources. In addition, this position will assist with knowledge transfer, and “Train-the-Trainer” programs per business needs. This position will help support in the implementation of new quality and compliance standards as needed to meet regulations and requirements of state, federal, and accrediting agencies. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.
Duties
Collaborates with UM Departmental Managers, Supervisors, and SMEs in assessing existing training materials, as well as designing and developing new training materials and schedules, establishing educational goals/ objectives; and coordinating with Reviewers (15%)
Manages databases and instructional hardware/software for documentation, testing, and maintaining all training materials including course materials, job aids, case studies, etc. (10%)
Provides weekly progress reports and recommendations based on observed trends to a designated department leader who determines the content and frequency of such reports. (10%)
Assists other Utilization Management Educators and Reviewers to conduct initial and/or ongoing education efforts or audits per business needs. Collaborates with UM Leadership to develop a standardized process for team member audits and rebuttal as well as an audit tool. (15%)
Serves as a lead to effectively deploy policy/procedure updates and regulatory requirements in a consistent and compliant manner. (5%)
Regularly performs quality check updates Authorization Technician relevant job aides, and other materials to ensure appropriate implementation. (10%)
Coordinates with Reviewer to review monthly audit report trends in collaboration with Subject Matter Experts, Supervisors, and Managers to develop and/or improve AT training programs. (5%)
Responsible for coordinating reviews and preparing for internal and regulatory audits of Utilization Management records; analyzing audit findings; making recommendations for corrective action plans; and implementing internal and external corrective action plans as it pertains to education and training of staff. (5%)
Partners with UM Leadership to develop and maintain new hire AT onboarding training, and existing staff re-training for all Utilization Management departments. Applies alternative training mediums and methods to increase training effectiveness and to accommodate distance learning, learning style and cultural differences. Coordinates AT annual presentations and educational opportunities. (15%)
Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed. (5%)
Perform other duties as assigned. (10%)
Duties Continued
Education Required
Education Preferred
Experience
Required:
At least 2 years of work experience as a Trainor in an acute or managed care setting.
At least 2 years experience processing authorizations.
Preferred:
Knowledge and experience with eLearning tools and internet technology.
Experience performing clinical documentation for a health plan.
Skills
Required:
Knowledge of medical terminology and AMA coding process (ICD-10, HCPC and CPT codes).
Strong verbal and written communication skills; computer literacy with proficiency with Microsoft Word, Excel, and Access.
Must demonstrate flexibility to meet changing training needs and must be a strong team player willing to work to accomplish team goals.
Adaptability to computer learning.
Good interpersonal and time management skills, with the ability to work independently.
Knowledge and understanding of the Health Insurance Portability and Accountability Act.
Knowledge of and ability to adopt various tools and methods to conduct pre- and post-training testing and associated analysis for test results with the purpose of improving training effectiveness.
Knowledge of and ability to identify what people need to learn for successful individual and organizational performance.
Knowledge of and ability to administer procedures, tools and logistics for a variety of training programs.
Ability to demonstrate critical thinking skills, high level of organizational and time management skills, strong analytical skills.
Able to demonstrate experience / knowledge in lesson and / or curriculum planning.
Outstanding, written, oral and presentation skills. Able to write effective and accurate instructional text and demonstrates excellent written and verbal presentation skills.
Skills in measurement and evaluation of training initiatives.
Preferred:
Knowledge and experience with Adobe Flash, Power Point, Excel, Word, Outlook, and Visio.
Proven ability to lead successful performance improvement projects strongly preferred.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
Additional Information
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
