Executive

We are looking for a Trainer responsible for creating content, delivering training, and updating training materials for our TPA operations team. The ideal candidate will have experience in training staff within the insurance or healthcare sector, specifically around TPA services and CMS guidelines. This role will focus on developing and maintaining training materials that ensure employees are well-equipped to manage back-office functions such as claims processing, enrollment, disenrollment, and other TPA services in compliance with regulatory standards.

Key Responsibilities:

Content Creation:

• Develop and create comprehensive training materials for TPA services, including training manuals, presentations, and eLearning modules.
• Ensure training content aligns with CMS guidelines and includes industry best practices for handling claims, enrollments, and provider payment processes.
• Customize content to meet the unique needs of onshore and offshore teams, ensuring relevance and accessibility for all learners.

Training Delivery:

• Facilitate in-person and virtual training sessions for new hires & existing employees in claims adjudication, member enrollment, customer service, and regulatory compliance.
• Deliver classroom-based training, workshops, and webinars, ensuring interactive and engaging learning experiences.
• Conduct refresher training sessions to ensure ongoing knowledge retention and skill enhancement.

Upkeep and Updating of Training Content:

• Regularly update training materials to reflect changes in CMS regulations, new process improvements, and evolving client needs.
• Monitor training effectiveness through feedback surveys, assessments, and performance tracking, and make adjustments as needed.
• Collaborate with subject matter experts (SMEs) and leadership to ensure training content remains current and relevant.

Compliance and Certification:

• Ensure that training materials and programs comply with industry standards, including HIPAA, SOC 2, and CMS requirements.
• Develop and track training certifications for staff to ensure they meet regulatory and operational standards.

Continuous Improvement:

• Collect and analyze training feedback to improve training delivery and effectiveness.
• Recommend and implement process improvements in training programs to enhance engagement, retention, and service quality.

Required Qualifications:

• Bachelor’s degree in Education, Training, Business Administration, or a related field.
• 5+ years of experience in training or learning and development, with a focus on TPA services or healthcare.
• Strong understanding of CMS regulations, claims processing, and TPA back-office operations.
• Experience in creating and delivering interactive training programs using modern learning technologies (e.g., LMS, eLearning platforms).
• Excellent presentation and facilitation skills, with the ability to engage and motivate learners.
• Strong communication and interpersonal skills for collaborating with teams and stakeholders.

Preferred Qualifications:

• Certification in Instructional Design or Training Delivery
• Experience with virtual training tools
• Knowledge of adult learning principles and learning needs analysis.

Key Competencies:

• Content Development: Strong skills in developing clear, effective, and engaging training materials.
• Leadership and Facilitation: Proven ability to lead and facilitate training sessions effectively.
• Regulatory Knowledge: Deep understanding of CMS guidelines and industry standards related to TPA services.
• Continuous Improvement: Focused on enhancing training programs to improve learner outcomes and operational efficiency.
• Analytical Thinking: Ability to assess training needs, collect feedback, and make data-driven decisions for content improvement.