Job Description

· We are seeking a Trainer – Case Management with strong Case Management, Specialty Pharmacy, and clinical education experience. This role requires a combination of clinical expertise, care coordination knowledge, adult learning principles, and performance coaching skills to prepare clinicians to deliver high-quality, patient-centered care for members receiving specialty therapies.

Clinical Trainer

· We are seeking a Trainer – Case Management with strong Case Management, Specialty Pharmacy, and clinical education experience. This role requires a combination of clinical expertise, care coordination knowledge, adult learning principles, and performance coaching skills to prepare clinicians to deliver high-quality, patient-centered care for members receiving specialty therapies.

o Facilitate new hire, upskilling, refresher, and ongoing clinical training in classroom, virtual, and blended learning environments.

o Deliver training on Case Management, care coordination, care planning, health coaching, motivational interviewing, medication adherence, transitions of care, chronic disease management, and specialty pharmacy workflows

o Deliver just-in-time (JIT) training and nesting/OJT support, coaching clinicians on client workflows, patient engagement, and care coordination best practices.

o Complete and maintain certification through the client-led Train-the-Trainer program

o Facilitate clinical simulations, role-play activities, case studies, and clinical decision-making exercises to reinforce learning and competency.

o Prepare and submit training reports, competency scorecards, certification trackers, nesting dashboards, and learner performance reports accurately and on time.

o Develop and maintain training materials, facilitator guides, job aids, assessments, and competency validation tools aligned with client requirements and evidence-based practice.

o Manage training schedules, logistics, LMS records, and learning resources

o Monitor learner progress through case studies, simulations, documentation reviews, knowledge assessments, call observations, and competency evaluations

o Provide coaching, feedback, and remediation plans during training and nesting to ensure readiness for independent practice.

o Partner with Operations, Clinical Leadership, Quality, and Client SMEs to ensure training reflects current workflows, quality requirements, and regulatory standards.

o Provide recommendations for curriculum enhancements based on learner feedback, quality trends, regulatory updates, and operational performance.

o Design and deliver refresher and upskilling programs based on client changes, quality findings, compliance requirements, and performance opportunities.

o Stay current with government and commercial payer requirements, CMS regulations, accreditation standards (NCQA, URAC), specialty pharmacy practices, evidence-based care management principles, and adult learning methodologies

o Support clinical quality improvement initiatives, competency validation programs, and transition-to-production activities

Qualifications

o Active USRN license (United States Registered Nurse).

o Minimum 5 years of clinical nursing experience

o Minimum 3 years of Case Management, Care Coordination, Disease Management, or related clinical experience

o Minimum 2 years of facilitation, adult education, or healthcare training experience

o Experience in member-facing, telephonic, virtual, or specialty pharmacy care management environments preferred.

o Knowledge of CMS regulations, NCQA, and URAC standards

o Strong administrative, reporting, documentation, and training management skills

o Proficiency in Microsoft Office Suite, Learning Management Systems (LMS), EMR/EHR platforms, and care management systems

o Proven ability to coach learners, validate competencies, and support production readiness

o Excellent communication and facilitation skills, with the ability to translate complex clinical concepts into practical learning experiences.

o Preferred certifications include Certified Case Manager (CCM) or Accredited Case Manager (ACM)

Skills

· Strong clinical judgment, case management expertise, and care coordination knowledge

· Knowledge of specialty pharmacy care models, medication adherence programs, and patient engagement strategies

· Ability to evaluate clinical competency and validate readiness for independent practice

· Skilled in coaching, mentoring, remediation planning, and performance feedback

· Knowledge of Motivational Interviewing, chronic disease management, Social Determinants of Health (SDOH), and evidence-based practice

· Ability to design and deliver clinical education, refresher training, and competency-based learning programs

· Proficiency in training documentation, reporting, assessment development, and performance analytics

· Strong curriculum development and instructional design awareness, including recommending content improvements based on learner and operational data.

· Strong communication, facilitation, and presentation skills, with the ability to simplify complex clinical concepts.

· Effective collaboration and stakeholder management across operations, clinical leadership, quality, and client teams.

· Strong time management, organization, and prioritization skills in a fast-paced healthcare environment.

· Demonstrated commitment to continuous improvement, quality outcomes, and workforce readiness

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