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Clinical Quality and Training Manager
<p><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Vālenz<sup>®</sup> Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible.<br><br><span style="line-height:normal;"><b><span style="color:#2b333a;">About This Opportunity:</span></b></span><br><span style="line-height:normal;"><span style="color:#2b333a;">As a Clinical Quality and Training Manager, you’ll help drive clinical excellence by leading audits, supporting quality improvement initiatives, and ensuring regulatory compliance. You’ll develop and manage training programs for clinical staff, use data to monitor performance, and identify opportunities to improve workflows. In addition, you’ll lead quality-focused discussions, help mitigate risk, and ensure documentation is thorough and up to standard.</span></span><br><br><span style="line-height:107%;"><b><span style="color:#2b333a;">Things You’ll Do Here</span><span style="color:#000000;">: </span></b></span></span></span></p><ul><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Conduct regular clinical audits to ensure compliance with industry standards and internal protocols.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Develop, update, and implement policies and procedures for registered nurses (RNs) to maintain clinical excellence.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Oversee URAC accreditation readiness and ongoing maintenance, ensuring adherence to all regulatory requirements.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Design and support workflows, particularly in response to changes in technology, to optimize clinical operations.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Design and oversee quality improvement programs that enhance patient care and clinical outcomes. </span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Develop and deliver training programs for clinical staff, focusing on compliance, new policies, and procedures, while ensuring that all training materials are up-to-date and effectively address the needs of the staff.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Collect, analyze, and report on quality metrics, identifying trends and areas for improvement. </span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Use data to guide decision-making and to track the effectiveness of quality initiatives.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Assist in the creation and optimization of clinical workflows, particularly during the implementation of new technology or process changes. </span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Facilitate meetings and committees focused on quality improvement, encouraging collaboration across departments and ensuring that all stakeholders are aligned on goals and strategies.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Monitor and manage risks associated with clinical practices, developing risk mitigation strategies as needed. </span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Ensure accurate and thorough documentation of quality management activities, including audits, training sessions, and compliance checks.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;"> Maintain records in accordance with organizational policies and regulatory requirements.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Support analytics and quality projects to ensure client needs are met, potentially including involvement with client meetings.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Assist with client reporting needs, such as reporting for MHPAEA (Mental Health Parity and Additional Equity Act) purposes.</span></span></span></span></li></ul><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="line-height:107%;"><i><span style="line-height:107%;"><span style="color:#000000;">Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.</span></span></i></span><br><br><br><span style="line-height:107%;"><b><span style="color:#2b333a;">What You’ll Bring to the Team</span><span style="color:#000000;">:</span></b></span></span></span><ul><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Bachelor’s degree in Nursing (BSN).</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">5+ years of experience in conducting clinical audits and managing healthcare quality policies.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Strong understanding of clinical practices, patient care standards, and regulatory requirements, particularly related to quality and training in healthcare.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">In-depth knowledge of healthcare regulations and accreditation standards, such as URAC, and the ability to ensure the organization meets these requirements.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Expertise in quality management principles, including experience in conducting audits, analyzing data, and implementing quality improvement initiatives.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Proficiency in designing and delivering effective training programs for clinical staff, with an emphasis on policy updates, compliance, and quality improvement.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Ability to manage multiple projects, coordinate with various stakeholders, and ensure timely completion of quality-related initiatives.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Strong analytical skills to interpret quality metrics, identify trends, and guide decision-making based on data.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Excellent leadership abilities, including mentoring junior staff, facilitating meetings, and effectively communicating with a diverse range of stakeholders.</span></span></span></span></li></ul><br><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="line-height:107%;"><i><span style="color:#000000;">A plus if you have…</span></i></span></span></span><ul><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Master’s degree in healthcare administration, or related field highly preferred.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Certified Professional in Healthcare Quality (CPHQ) or similar quality management certifications.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Certified Case Manager (CCM) or willingness to obtain.</span></span></span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><span style="color:#000000;"><span style="line-height:107%;">Experience working in the payor space for Case Management and/or Utilization Management.</span></span></span></span></li></ul><p><br><br><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><b>Where You’ll Work:</b> This is a fully remote position, and we’ll provide all the necessary equipment!</span></span></p><ul><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><b>Work Environment:</b> You’ll need a quiet workspace that is free from distractions.</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><b>Technology:</b> Reliable internet connection—if you can use streaming services, you’re good to go!</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><b>Security:</b> Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software.</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><b>Location:</b> You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.</span></span></li></ul> <p><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><strong>Why You'll Love Working Here</strong></span></span></p><p><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Valenz is proud to be recognized by Inc. 5000 as one of America’s fastest-growing private companies. Our team is committed to delivering on our promise to <b><i>engage early and often for smarter, better, faster healthcare</i></b><i>.</i><b> </b>With this commitment, you’ll find an engaged culture – one that stands <b><i>strong, vigorous, and healthy </i></b>in all we do.</span></span><br> </p><p><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;"><strong>Benefits</strong></span></span></p><ul><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Spending account options: HSA, FSA, and DCFSA</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">401K with company match and immediate vesting</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Flexible working environment</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Generous Paid Time Off to include vacation, sick leave, and paid holidays</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Employee Assistance Program that includes professional counseling, referrals, and additional services</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Paid maternity and paternity leave</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Pet insurance</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Employee discounts on phone plans, car rentals and computers</span></span></li><li><span style="font-size:12px;"><span style="font-family:Arial, Helvetica, sans-serif;">Community giveback opportunities, including paid time off for philanthropic endeavors</span></span></li></ul><p><em>At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.</em></p>