Talent.com
No longer accepting applications
Clinical Information Systems Specialist (PEGA / CCA / LTSS) - REMOTE

Clinical Information Systems Specialist (PEGA / CCA / LTSS) - REMOTE

Molina HealthcareOwensboro, KY, US
15 hours ago
Job type
  • Full-time
  • Remote
Job description

JOB DESCRIPTION

Job Summary

Provides support for development of educational / training content and resources for clinical systems applications / platforms. Responsible for implementation and training delivery for utilization management, care management, long-term services (LTSS), behavioral health, and other applicable clinical systems functions. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

  • Responsible for research, workflow analysis, content development, training, implementation, and on-going support of the electronic medical record (EMR) / practice management (PM) application (clinical systems applications / platforms).
  • Identifies, troubleshoots, and documents clinical system platform EMR / PM system functionality issues.
  • Creates and provides training related to the clinical system platform EMR / PM application for impacted individuals.
  • Escalates and responds to application malfunctions to related groups such as information technology and help desk support.
  • Performs research and analysis of customer-initiated inquiries and requests, utilizing technical tools as necessary and solutioning to enhance the end user experience.
  • Fields direct questions from Molina operations staff regarding business, technical and operations rules to the appropriate product owners / teams.
  • Creates, presents, and executes test cases in accordance with the requirements of the solution / project.
  • Understands changes in process that may impact the customer, and notifies the customer of such changes well ahead of their implementation through educational resources.
  • Collaborates with team members, leaders, and stakeholders to develop and design training content, including identification of goals, objectives, critical success factors and success measures.
  • Reeducates staff via group facilitation and / or individual coaching when deficiencies in performance are identified to mitigate skill gaps.
  • Educates users on system functionality and navigation.
  • Creates and uses clinical case scenarios to simulate how training participants will navigate systems and apply their skills and knowledge on the job.
  • Maintains working knowledge of state-specific regulations to ensure references and resources are included in training materials.
  • Serves as a subject matter expert on assigned clinical system platforms / applications. Consults with clinical organizations across
  • Molina to understand clinical business training needs.
  • Applies critical-thinking skills and breaks down complex information into simplified categories so it is easier for learners to understand and apply.
  • Evaluates training effectiveness to ensure staff understanding and readiness - analyzing and determining training needs / problems and providing clear and timely verbal and written feedback on issues to team members and leadership.
  • Participates in committees and / or workgroups as a liaison between training teams and workgroups to ensure alignment with training and influence best practices.
  • Evaluates analytical data on end user application of clinical systems to identify training opportunities and trends.

Required Qualifications

  • At least 2 years experience in clinical systems analysis, and 1 year experience in a care management, utilization management, behavioral health, medical, or managed care setting, or equivalent combination of relevant education and experience.
  • Proficient in clinical systems implementation, integration, and administration content development.
  • Ability to work in a project team setting while also able to complete tasks individually within the provided timeline / accelerated timeline to meet desired deployment deadlines.
  • Strong detail orientation.
  • Organization and time-management skills.
  • Analytical and problem-solving skills.
  • Strong interpersonal skills.
  • Excellent verbal and written communication skills.
  • Microsoft Office suite / applicable software program(s) proficiency.
  • Preferred Qualifications

  • Training delivery and / or development experience, to include adult learning concepts.
  • To all current Molina employees : If you are interested in applying for this position, please apply through the Internal Job Board.

    Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V

    #PJClaims

    Pay Range : $77,969 - $117,809 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • Create a job alert for this search

    Clinical Information • Owensboro, KY, US

    Related jobs
    CLINICAL INFORMATICS ANALYST II - NURSING

    CLINICAL INFORMATICS ANALYST II - NURSING

    owensboroworkdaytestOwensboro, Kentucky, United States, 42303
    Full-time
    CLINICAL INFORMATICS ANALYST II - NURSING.Works to ensure that strategic health information technology, analytic development, and clinical data management are aligned with the requirements / needs of...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    RN Care Review Clinician Remote

    RN Care Review Clinician Remote

    Molina HealthcareOwensboro, KY, US
    Remote
    Full-time
    The RN Care Review Clinician provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established cli...Show moreLast updated: 14 hours ago
    • Promoted
    Travel Nurse - RN - MS - Medical Surgical - $1942.2 / Week - Hiring Now

    Travel Nurse - RN - MS - Medical Surgical - $1942.2 / Week - Hiring Now

    Premier Medical Staffing Services, LLCTell City, IN, US
    Full-time
    Premier Medical Staffing Services, LLC is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Tell City, IN. Shift : 3x12 hr nights Start Date : 12 / 08 / 2025 D...Show moreLast updated: 3 days ago
    • Promoted
    Care Review Clinician (RN)

    Care Review Clinician (RN)

    Molina Healthcare CareersOwensboro, KY, United States
    Full-time
    For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside.This role will be doing Utilization review for our Ohio Medicaid population, looking for clin...Show moreLast updated: 14 days ago
    • Promoted
    Lead Clinician

    Lead Clinician

    The Methodist Home of Kentucky, Inc.Owensboro, KY, US
    Full-time
    LEAD CLINICIAN - CAMINOS PROGRAM.Clinician focused on personalized, non-insurance-based support .Do you have a passion for youth? Do you want to see every child have a bright future? Join the ...Show moreLast updated: 30+ days ago
    • Promoted
    Care Review Clinician, PA (RN)

    Care Review Clinician, PA (RN)

    Molina Healthcare CareersOWENSBORO, Kentucky, US
    Full-time +1
    Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, inc...Show moreLast updated: 14 days ago
    CLINICAL PROGRAM SPECIALIST - QUALITY

    CLINICAL PROGRAM SPECIALIST - QUALITY

    owensboroworkdaytestOwensboro, Kentucky, United States, 42303
    Full-time
    CLINICAL PROGRAM SPECIALIST - QUALITY.Provides oversight, consultation, research, management, and education in performance improvement and patient safety. Coordinates activities and projects to meet...Show moreLast updated: 30+ days ago
    Clinician - Licensed

    Clinician - Licensed

    The Methodist Home of Kentucky, Inc.Owensboro, KY, US
    Full-time
    Quick Apply
    CLINICIAN - CAMINOS PROGRAM Clinician focused on personalized, non-insurance-based support Do you have a passion for youth?. Do you want to see every child have a bright future?.Join the team ...Show moreLast updated: 18 days ago
    • Promoted
    Travel Nurse - RN - MS - Medical Surgical - $2195 / Week - Hiring Now

    Travel Nurse - RN - MS - Medical Surgical - $2195 / Week - Hiring Now

    Staffmax Healthcare StaffingTell City, IN, US
    Permanent
    Staffmax Healthcare Staffing is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Tell City, IN. Shift : 3x12 hr nights Start Date : 12 / 08 / 2025 Duration : 1...Show moreLast updated: 3 days ago
    • Promoted
    Care Review Clinician, PA (RN)

    Care Review Clinician, PA (RN)

    Molina HealthcareOwensboro, KY, US
    Full-time
    Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, inc...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse - RN - MS - Medical Surgical - $1977.84 / Week - Hiring Now

    Travel Nurse - RN - MS - Medical Surgical - $1977.84 / Week - Hiring Now

    TRS HealthcareTell City, IN, US
    Full-time
    TRS Healthcare is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Tell City, IN. Shift : 3x12 hr nights Start Date : 12 / 08 / 2025 Duration : 13 weeks Pay : $...Show moreLast updated: 3 days ago
    • Promoted
    • New!
    Care Review Clinician (RN)

    Care Review Clinician (RN)

    Molina HealthcareOwensboro, KY, US
    Full-time
    For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside.This role will be doing Utilization review for our Ohio Medicaid population, looking for clin...Show moreLast updated: 15 hours ago
    • Promoted
    • New!
    RN Care Review Clinician Remote

    RN Care Review Clinician Remote

    Molina Healthcare CareersOwensboro, KY, United States
    Full-time
    The RN Care Review Clinician provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established cli...Show moreLast updated: 7 hours ago
    • Promoted
    • New!
    RN UM Care Review Clinician Remote

    RN UM Care Review Clinician Remote

    Molina Healthcare CareersOWENSBORO, Kentucky, US
    Remote
    Full-time +1
    The RN Care Review Clinician provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established cli...Show moreLast updated: 10 hours ago
    • Promoted
    Travel Nurse - RN - Home Health - $1650.28 / Week

    Travel Nurse - RN - Home Health - $1650.28 / Week

    Host HealthcareMadisonville, KY, US
    Full-time
    Host Healthcare is seeking an experienced Home Health Registered Nurse for an exciting Travel Nursing job in Madisonville, KY. Shift : Inquire Start Date : 11 / 19 / 2025 Duration : 13 weeks Pay : $1650.At ...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse - RN - Home Health - $1650.28 / Week - Hiring Now

    Travel Nurse - RN - Home Health - $1650.28 / Week - Hiring Now

    Host HealthcareMadisonville, KY, US
    Full-time
    Host Healthcare is seeking an experienced Home Health Registered Nurse for an exciting Travel Nursing job in Madisonville, KY. Shift : Inquire Start Date : 11 / 19 / 2025 Duration : 13 weeks Pay : $1650.At ...Show moreLast updated: 30+ days ago
    APPEALS SPECIALIST

    APPEALS SPECIALIST

    owensboroworkdaytestOwensboro, Kentucky, United States, 42303
    Full-time
    Responsible for denial management on all governmental and commercial payers, including inpatient and outpatient claims.Conducts chart audits to determine most appropriate course of action when paye...Show moreLast updated: 30+ days ago
    • Promoted
    Director of Clinical Services

    Director of Clinical Services

    TEEMA GroupOwensboro, KY, US
    Full-time
    The Director of Clinical Services is a visionary healthcare leader responsible for ensuring high-quality, patient-centered clinical care 24 / 7 across multiple care settings.This role champions excel...Show moreLast updated: 19 days ago