Training Specialist Utilization Management

The Training Specialist is responsible for developing, implementing, and maintaining training programs for non-clinical employees within the Utilization Management Division. This role serves as the primary resource for Epic and operational training, ensuring staff competency in departmental workflows, work queue management, payer portal access and utilization, productivity reporting tools, and related Utilization Management processes. The position supports onboarding, continuing education, retraining initiatives, and workflow optimization for both clinical and non-clinical Utilization Management staff.

Training Development and Implementation:

• Develops, provides, and maintains training programs for new non-clinical employees and Epic training within Utilization Management, including standardized training curricula, learning pathways, educational resources, and job aids to support staff development and operational effectiveness.

• Provides ongoing analysis to identify training needs in Utilization Management and develops, updates, and delivers training, re-training, and educational resources related to workflows, system enhancements, process improvements, and regulatory updates affecting Utilization Management operations.

• Evaluates workflows, work queue management, payer portal access and usage, educational training and re-training assignments, and productivity tool utilization to identify opportunities for improvement and support effective Utilization Management operations.

• Proactively communicates and collaborates with UM Leadership and staff to identify, communicate, and resolve training issues, knowledge gaps, and re-education requirements that impact or impede efficient workflow and operational performance.

Education/Training Programs:

• Creates and maintains all training materials, documentation, and educational resources to support new hire training, continuing education, and operational training initiatives within Utilization Management.

• Maintains training schedules for new hire training and continuing education and conducts baseline competency testing, post-training competency testing, and new hire course training to support employee development and competency validation.

• Provides education and training related to Medicare, Medicaid, commercial payer requirements, medical necessity criteria, regulatory standards, organizational policies, and Utilization Management workflows, including Epic functionality, work queue management, and portal processes.

• Monitors and analyzes quality, productivity, training, and competency metrics to evaluate training effectiveness, identify educational needs, and recommend process and training improvements to support Utilization Management operations.

Quality:

• Participates in the Utilization Management monthly Quality Assessment process through the assessment and evaluation of employee performance, audit findings, and opportunities for improvement to identify training and development needs.
• Collaborates with Central Utilization Management Leadership to review Quality Assessment findings, audit results, and training needs and implement appropriate training and improvement initiatives to support employee success and operational effectiveness.

Experience: 1 year of teaching/training experience

Education: Bachelor’s degree in healthcare administration, Heath Information Management, Business Administration, Education, or Related Field. An epic certification with 5 years of healthcare experience can substitute for degree.