Senior Specialist, Delegation Oversight (Remote)

Remote Full-time
Job Description

Job Summary

Responsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance requirements including delegation standards and requirements contained in the Molina Medical Compliance and Fraud, Waste and Abuse Program.

Knowledge/Skills/Abilities
• Coordinates, conducts, and documents delegation assessments as necessary to comply with state, federal, NCQA, and any other applicable requirements.
• Prepares status reports from Delegated Entities. Develops corrective action plans when deficiencies are identified, and documents follow-up to completion. Ensures compliance with reporting requirements by tracking the receipt and completeness of reports.
• Develops corrective action plans when compliance issues are identified, and document follow-up to completion.
• Assists with meetings of the Delegation Oversight Committee, including the preparation of documents for committee oversight of delegated functions.
• Works with Network Management team to develop and maintain delegation agreements and assessment tools.
• Prepares delegation oversight document evidence for state monitoring visits and NCQA accreditation surveys and participates on Molina's work team.

Job Qualifications

Required Education

Bachelor's Degree or equivalent combination of education and experience.

Required Experience
• 3+ years managed care experience.
• Min. 1 year experience completing delegation oversight assessment/ audits.
• Data analysis experience.

Required License, Certification, Association

Valid State Driver's License

Preferred Education

Bachelor's Degree in Business or Health Care related field.

Preferred Experience
• 5 years managed care experience.
• 2 years’ experience completing delegation oversight assessments/audits.
• Quality management/regulatory experience with increasing responsibility.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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

Pay Range: $45,390 - $85,511 / ANNUAL
• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Apply Now
Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Staff Research Scientist

Remote

Software Engineer II (Remote)

Remote

[Remote] Regional Account Manager - OL Connecticut

Remote

UKIMEA Advisory and Professional Services Sovereign AI Enterprise Architect

Remote

Work from Home: Medical Transcriptionist Jobs with No Experience

Remote

Care Guide Team Manager

Remote

Remote Teen Online Data Entry Associate – Flexible Hours, $15‑$20/hr at arenaflex

Remote

Remote -editor​/Proofreader

Remote

Water Resources Compliance and Metering Coordinator (Environmental Specialist 5)

Remote

Senior Catastrophe Claims Adjuster

Remote
← Back