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Blue Cross Blue Shield of Arizona Logo Blue Cross Blue Shield of Arizona · Health and Beauty

Clinical Trainer and Auditor

United States, Phoenix · Job Posted June 09, 2026
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Job Description

Responsible for developing and delivering clinical curriculum, developmental programs and services to assist with achievement of goals and initiatives. Responsible for conducting clinical audits and reviews to ensure standardization and consistency with nurse reviewer clinical decisions.

Job Responsibility

  • Develop and educate clinical staff on the company's clinical philosophy and evidence based practice methods
  • Identify training needs outside of core curriculum to promote maximized effectiveness
  • Maintain and monitor the delivery and effectiveness of the training programs
  • Assist with the development and evaluation of performance goals and objectives and quality management activities
  • Develop and facilitate new hire orientation for the clinical staff
  • Performs quality audits and facilitates inter-rater reliability assessments
  • Support and provide education with process improvement programs and technical applications
  • Develop programs to support educational needs as determined by management
  • Present status reports on all cases to the manager/supervisor
  • Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements
  • Maintain complete and accurate records per department policy
  • Participate in continuing education and current development in the field of medicine and managed care
  • Facilitate interdisciplinary care round/discussions under the direction of the VP, Clinical Benefit Management and/or delegate
  • The position requires a full-time work schedule
  • Perform all other duties as assigned

Requirements

  • 5 years of direct clinical care experience in a healthcare setting
  • 2 years of work experience in a managed care setting
  • 4 years of clinical training or clinical education experience, preferably in managed care
  • Associate Degree or in Nursing
  • Active, current, and unrestricted license to practice in the State of Arizona as a Registered Nurse (RN) or Master’s in Social Work (MSW)

Nice to have

  • 5 years of experience in clinical education, training and instructional design
  • 1 year of experience working with Milliman Care Guidelines (MCG), InterQual and/or other clinical criteria/guidelines
  • Bachelor's Degree in Nursing or Master’s Degree in Nursing
  • Certified Case Manager (CCM) or Utilization Management Certification
  • Advanced PC proficiency
  • Knowledge of CPT/HCPCs and ICD-10 coding
  • Knowledge of managed care, utilization management, and quality management

What we offer

  • Hybrid workforce strategy called Workability that offers flexibility
  • Remote work opportunity within the State of Arizona
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