Referral Management (RN) Traning Manager (Bethesda, MD)

Ivyhill is currently seeking to hire Referral Management (RN) Training Manager to support its contract with the Integrated Referral Management and Appointing Center (IRMAC), the National Capital Regions’ premier coordinating authority for appointing and referral management services for beneficiaries in the Defense Health Network. 

Referral Management (RN) Training Manager viewers will have overall responsibility for implementing and evaluating the in-house/new hire training for Referral Management Reviewers and managing DOD specific training.

This is an onsite employment opportunity.  However, consideration will be provided for teleworking upon customer's approval.

Duties and Responsibilities

1. Provide Referral Management (RM) training to all incoming RM staff to be able to accurately review referrals utilizing the Specialty Referral Guideline (SRG) compliance for disposition per IRMAC guidelines.
2. Train, orient and competency assess RM staff to ensure proficiency in performing the referral duties upon completion of training.
3. Develop training topics based on monitoring observations, changes to standards, policies, and procedures.
4. Provide remedial and updated training to staff based on changes in the organization.
5. Create initial and annual competency assessment for RM staff, ensuring completion after initial training and annually afterwards. Identify gaps in performance and provide a training plan based on assessment to meet the staff’s individual needs.
6. Develop and coordinate online and in-house training to account for IRMAC staff and the NCR weekly training sessions to ensure all staff receive adequate training on all topics.
7. Complete training on the components of a correct review; when to accept, reject and send to the network.
8. Must be knowledgeable of the Managed Care Support Contractor (MCSC) requirements, booking protocols and the Right of First Refusal (ROFR) process.
9. Must be knowledgeable and able to perform all the duties and requirements of the Referral Registered Nurse and the the RM Reviewers.

Requirements

Qualified candidate must be a Licensed Registered Nurse (RN), with an unencumbered active RN license from a State Board of Nursing and graduated from an accredited nursing program.

Must have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management (UM) experience is preferred. Full-time employment in a nursing field within the last 24 months is mandatory.

Additionally, the qualified candidate must:

1. Be a U.S. Citizen.
2. Have knowledgeable, skills and computer literacy to interpret and apply medical care criteria, such as InterQual, Milliman Ambulatory Care Guidelines, Specialty Referral Guidelines (SRGs) or other evidence-based guidelines identified by the MHS.
3. Be proficient in the usage and understanding of medical terminology, MHS, VA-DOD Sharing Program, TRICARE, HIPAA, release of medical information.
4. Have demonstrated ability to manage a high-performing and efficient team.
5. Have excellent oral and written communication skills, interpersonal skills, superior customer service, leadership, and organizational skills.
6. Have a working knowledge of computers, specifically the Internet, Microsoft Word, Microsoft PowerPoint, Microsoft Access, Microsoft Excel, and Windows.

Benefits

Ivyhill has a competitive benefits program which includes medical, dental and vision; Life and AD&D insurance; Short- and Long-Term Disability; supplemental Life insurance and a 401(k) Plan.

Ivyhill is an equal opportunity employer. In compliance with Federal and State Equal Opportunity Laws, qualified applicants are considered for all positions applied for without regard to race, color, religion, sex (including pregnancy and gender identity) , national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, veteran status or any other legally protected status.