This role is responsible for effective delivery of training of HEDIS/STAR programs across the organization with a focus on pharmacy measures. The Quality Training Clinical Pharmacy Lead keeps abreast of various training delivery techniques, business processes, products and systems. This role assists in the designing, managing, implementing and evaluating of training of Quality programs to prepare high quality and highly competent staff for meaningful contributions in the workplace. This position will work with Quality training for new employee on-boarding, clinical orientation/training related to Quality departments, HEDIS and audit modules, staff competencies, and any new training initiatives. This position facilitates training to all new quality department members and acts as the Part D training measures SME.
If you are located within commutable distance of San Antonio, TX with the ability to go into WellMed San Antonio offices, you will have the flexibility to telecommute* as you take on some tough challenges.
- Implements staff development and clinical staff competency programs incorporating appropriate adult learning principles
- Conducts Quality training and education programs for pharmacists, providers, registered and practical/vocational nurses and other staff/departments/clinics as assigned
- Provides training on HEDIS/Star Measures, preventive health topics with a focus on medications, their use, side effects and access to medications
- Provides training to the clinical team to research and designs educational materials for use in practitioner offices; serves as liaison with key vendors supporting Part D HEDIS/Star Measures; consults with vendors to design and implement initiatives to innovate and then improve HEDIS/Star Measure rates
- Provides explanations, insight and expertise on the most complex pharmacy issues to staff and providers
- Follows plan for professional development and actively seeks out opportunities to increase expertise in health care education and quality training programs
- Work with instructional design staff to ensure all new initiatives, policies and procedures, guidelines, or other necessary updates are incorporated into orientation/training programs
- Identify innovative training strategies for learners, including distance learners
- Leverages creativity and utilizes a wide variety of methods to present education and training programs
- Designs practice level quality transformation through targeted clinical education and approved materials related to HEDIS/State Specific quality measures for providers and staff education during field visits
- Educates the staff on proper clinical documentation, coding, and billing practices, state-mandated quality metrics specifications, provider profiling and pay for performance
- Evaluates the results of post-program surveys and processes to obtain participant feedback
- Conducts competency skill evaluations at least yearly to ensure ongoing monitoring of skills and performance
- Educates the staff on how to investigate gaps in clinical documentation where system variation has impact on rate calculation, and how to provide effective feedback to providers and appropriate departments
- Provides role-based training to learners for specific behavior and skill development utilizing effective feedback and motivational support techniques
- Serves as a SME, leader and mentor for Part D metrics for providers, clinical and non-clinical staff providing expert input
- Oversight and responsibility for Part D presentations and training materials
- Collaborate with learner's manager and the instructional design team to identify and provide training needs for staff
- Provide learner specific feedback and recommendations to learner's manager
- Follows plan for professional development and actively seeks out opportunities to increase expertise in nursing education and adult training programs
- Provides excellent customer service, monitors quality service and customer service delivery
- Leads and serves on corporate committees, task forces, and/or work groups
- Leads special pharmacy-related educational projects and innovations
- Performs all other related duties as assigned
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Degree consistent with practitioner experience (Masters, Doctorate, PharmD, BS Pharmacy, etc.)
- 5 years of experience in managed care and/or pharmacy management/retail pharmacy or clinical setting, hospital, clinic, provider office or other facility
- Practitioner with current or history of prescription privileges or who is eligible to practice. This may include Pharmacist, NP, MD/DO, PA
- Proficiency with Microsoft Office applications
- Knowledge of the managed care, disease management and complex care case management, basic principles and practices of clinical nursing, adult learning principals
- Experience with an electronic medical record documentation
- Business experience within the health care industry including at least 1 years of experience with HEDIS/Stars
- Experience presenting education of HEDIS/Stars material to providers and provider office staff
- Strong communication and presentation skills
- Strong relationship building skills with clinical and non-clinical personnel
- Demonstrated ability to interact with medical staff, peers, and internal company staff at all levels
- Previous training experience
- Strong knowledge of the Medicare market, products and competitors
- Problem-solving and decision-making skills
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000 lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
- All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: training, WellMed, Optum, Pharmacy, RX, Practitioner, San Antonio, TX, Texas