Harris Health System

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Training Manager/STAR+PLUS/CHC

at Harris Health System

Posted: 1/3/2019
Job Status: Full Time
Job Reference #: 144349
Keywords:

Job Description

About Us

Community Health Choice, Inc. (Community) is a non-profit Health Maintenance Organization (HMO) licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 70 hospitals, Community serves over 260,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Job Profile

The Training Manager,STAR+PLUS collaborates with the departmental management team to assess, plan, develop and implement orientation and onboarding programs, new system or program training and re-training, and educate/re-educate staff at Community Health Choice on the appropriate use of policies, evidence-based guidelines, or other authorization criteria as adopted by the health plan. This position will participate in creating policies and procedures as well as be responsible for completing the training on all HHSC STAR+PLUS required assessments and forms such as Medical Necessity Level of Care (MN/LOC), H2060, and H6516. This trainer also facilitates education, training and re-training on appropriate telephone skills to staff who regularly handle incoming or outbound calls. In addition, the trainer works with the departmental management team to develop and implement regular Inter-rater Reliability Reviews for clinical staff whose job includes all STAR+PLUS functions to ensure consistent application of policies, evidence-based guidelines, regulatory requirements, and/or other authorization criteria as adopted by the health plan. Responsible for all STAR+PLUS training staff.

QUALIFICATIONS:

  • BSN preferred. Active Texas nursing license required.
  • RUG certification preferred or must be obtained within the first 30 days.
  • Three to five years experience in STAR+PLUS WAIVER managed care health plan and two years experience as a trainer are preferred.
  • Two years management experience required.

OTHER SKILLS:

  • Above Average Verbal communication skills; (Heavy Public Contact)
  • Above average written communication skills: (Writing /Composing, Correspondence)
  • MS Word/ MS Excel
  • STAR+PLUS knowledge exceptionally in regards to Waiver requirements.
  • Some travel required.


Benefits and EEOC

Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.

Community is an Equal Opportunity Employer.

Job Category

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Application Instructions

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