Utilization Management Clinical Trainer; Hybrid Remote

About the Role

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. The Utilization Management Clinical Trainer plays a vital role in onboarding and developing clinical staff to ensure high‑quality, consistent, and compliant utilization review services. This position is responsible for designing and delivering training programs for new utilization review nurses and coordinators, as well as providing ongoing education and support to current team members.

The trainer collaborates with other clinical trainers to create standardized training materials that support clinical consistency across roles at Alignment.

This position is primarily remote; however, in‑person attendance at Alignment Health’s headquarters in Orange, CA is required approximately once per quarter for leadership meetings and team collaboration. Candidates located outside of California should expect periodic travel to the Orange office. Travel expenses are reimbursed in accordance with company policy.

• Develop and implement onboarding and training programs for new staff in the utilization review process.
• Create and maintain utilization review clinical training materials, quick‑reference guides, and job aids that reflect up‑to‑date policies, processes, and review criteria.
• Design utilization review and other clinical training content to support standardized workflows used by all clinical reviewers, ensuring clarity and consistency across the clinical teams.
• Collaborate with all trainers (clinical and non‑clinical) to ensure consistency in approach and style across the organization.
• Deliver engaging, practical education using real‑world examples and case studies.
• Design and deliver training for new processes, tools or platforms to ensure confident adoption and effective daily use.
• Adapt training to reflect evolving regulatory environments, including state‑specific utilization review requirements and client‑specific clinical policies.
• Participate in routine and targeted audits of medical necessity reviews to ensure quality, compliance, and appropriate clinical decision‑making.
• Collaborate with the Compliance Officer to conduct interrater reliability (IRR) assessments to ensure consistency among reviewers.
• Identify trends, gaps, or performance issues through audit and IRR results, and develop targeted training to address findings.
• Assist the compliance officer with tracking and reporting on training completion, clinical quality improvements, and IRR improvements over time.
• Support leadership in maintaining compliance with compliance standards and other applicable guidelines.
• Serve as a resource for clinical staff, offering guidance on accessing and interpreting clinical protocols, documentation practices, and decision‑making frameworks.
• Collaborate with clinical leadership to identify training needs and support operational goals.
• Ensure consistency in training documentation across all clinical teams, including those supporting physician review.
• Promote a positive, engaged team culture that reflects ICM’s values of kindness, personal responsibility, humble confidence, and a can‑do attitude.
• Contribute to clinical team engagement by supporting professional development, building confidence in decision‑making, and promoting a shared understanding of clinical expectations.
• Perform other duties as assigned.

• Experience:
  
  Minimum of 5 years nursing experience in managed care, utilization review, case management, quality improvement, or acute care nursing—particularly roles involving interdisciplinary coordination, clinical documentation review, or patient discharge planning.
• Experience developing and delivering clinical training preferred; candidates without formal training experience may still be considered if they demonstrate strong clinical communication skills and a passion for developing others.
• Comfort with technology platforms used for clinical documentation, utilization review, and virtual training delivery.
• Education:
  
  Bachelor’s degree in Nursing, Health, or Education related field.
• Licensure:
  Active and unrestricted…