{"id":1545451,"url":"https://alion.io/job/azblue-clinical-trainer-auditor-remote-az","title":"Clinical Trainer & Auditor - Remote AZ","company":{"id":2023904,"name":"Blue Cross Blue Shield of Arizona","domain":"azblue.com","url":"https://alion.io/company/azblue","size_band":"1001-5000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"A","score":90,"open_postings":5,"ghost_share":0,"stale_share":0.4,"repost_share":0,"time_to_fill_p50_days":36,"computed_at":"2026-10-24T06:02:35Z"}},"role":"Education","role_family":"Education","seniority":"senior","employment_type":"full_time","work_mode":"hybrid","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Phoenix, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":63000,"max_usd":126000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":415},"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-07-31T00:00:00Z","employer_posted_date":"2026-10-12","last_verified_at":"2026-10-22T05:38:36Z","board_verified":false,"closed_at":null,"days_open":85,"trust":{"level":"ok","repost_count":1,"flags":[],"days_open":85},"description":"Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.\nAt AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:\nHybrid People Leaders: must reside in AZ, required to be onsite at least twice per week\n\nHybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week\n\nHybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions):must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month\n\nOnsite: daily onsite requirement based on the essential functions of the job\n\nRemote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building\n\nPlease note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.\nThis remote work opportunity requires residency, and work to be performed, within the State of Arizona.\nPURPOSE OF THE JOB\nThe Clinical Trainer and Auditor is responsible for planning, developing, delivering, coordinating, and evaluating a variety of clinical education programs for health plan clinical operations staff. Training programs include but aren’t limited to that required for NCQA accreditation, New Hire Orientation, Annual Training, Model of Care Training, and CMS and AHCCCS requirements.\nQUALIFICATIONS\nREQUIRED QUALIFICATIONS\nRequired Work Experience3 years’ experience in clinical care\n2 years of work experience in a managed care setting\nPrior experience in NCQA Surveys, CMS Program Audit, and/or AHCCCS Operational Review\nPrior audit experience \nRequired Education\nBachelor degree in Nursing\n Required LicenseActive, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN within the first 60 days of hire.\nRequired Certifications\nN/A\nPREFERRED QUALIFICATIONS\nPreferred Work Experience5 years’ experience in clinical care\nPhysical and behavioral health experience\n2 years’ experience in a training role\n5 years’ experience working in a managed care organization\nTraining program development\nKnowledge of population health concepts and models\nKnowledge of medical and care management models\nKnowledge of IRR process\nPreferred Education Master’s Degree in Nursing\nPreferred LicensesN/A\nPreferred CertificationsN/A\nESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES\nConsults with clinical operations leaders to identify, develop, and respond to training needs and requests Develops curriculum, maintains currency, and revises as appropriate Plan, coordinate, deliver, and evaluate clinical training for clinical operations programs, including:\nNew hire onboarding\nAnnual Training\nCustomer service excellence\nQuality and performance metrics\nOngoing professional growth, compliance, and regulatory training\nServe as a resource for staff in areas of clinical practice, clinical professional development, using coaching, mentoring, effective feedback, and motivation support techniques\nServe as subject matter expert on policies and procedures, and desktop procedures related to NCQA, CMS, and AHCCCS requirements\nUtilize a variety of the training methodologies, techniques, concepts, learning tools, and practices\nProvide online and conference call training session for remote employees\nDevelop valid exercises designed to provide effective hands-on practice to new and existing employees\nMonitor and report on the effectiveness of education/training programs\nCreate and develop training for employees not able to meet or maintain standards of excellence\nDevelops audit tools that meet NCQA, CMS, and AHCCCS requirements\nPerform case reviews/audits and IRR analysis, according to standards\nAudits staff phone calls and written documentation according to policy\nConducts periodic audits of documents such as HRA, ETI, Assessments, Care Plans, Medical Necessity Documentation to ensure compliance\nProvide documentation of staff training according to accreditation and regulatory requirements\nCollaborate with BCBSAZ Training and Workforce Development department\nParticipate in continuing education and current developments in the field of accreditation, medicine, behavioral health, social determinants of health, and managed care at least annually.\nThe position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.\nPerform all other duties as assigned\nMaintain a thorough knowledge of all BCBSAZ medical coverage guidelines and other policies\nAssist manager with policy and practice guideline development and revisions as well as necessary coaching to help each staff member reach personal, professional and department goals\nCOMPETENCIES\nREQUIRED COMPETENCIES\nRequired Job Skills\nIntermediate PC proficiency: Intermediate skill in word processing, spreadsheet, and database software\nExcellent communication, collaboration, and training skills.\nAbility to manage multiple tasks and prioritize work to adhere to deadlines and identified time frames\nAbility to learn new applications\nRequired Professional Competencies\nKnowledge of NCQA, CMS, and AHCCCS Standards \nDemonstrates knowledge of accreditation, regulatory, and certification requirements Current clinical knowledge\nCollaborates with Information Technology to maximize the utilization of the medical management system (CareRadius) and technologies to support compliance \nInterpret and translate policies, procedures, programs and guidelines\nCommunicate outcomes to leadership\nUnderstand and interpret data to effectively create curriculum based on needs identified\n\nPREFERRED COMPETENCIES\nPreferred Job Skills\nAdvanced PC proficiency\nAdvanced processing, spreadsheet and presentation software proficiency\nDetail Oriented\nResults driven\nStrong organizational skills\nPreferred Professional Competencies\nUses formal instructional design methodology to develop and support sophisticated, complex and/or enterprise-wide, competency-based training, skills, and education\nPreferred Leadership Experience and Competencies\nDemonstrated skills and competence in training methods\nDemonstrates effective presentation skills\nOur Commitment\nAZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.\nThank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. 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