Molina Healthcare

Senior Specialist, Delegation Oversight (Remote)

Molina Healthcare$75K — $95K *
US-AnywhereRemote in Long Beach, CA
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 3+ years of managed care experience or equivalent education/experience in delegation oversight activities.
  • Experience in data analysis and reporting.
  • Ability to manage multiple projects and work both independently and collaboratively.
  • Strong attention to detail and excellent organizational skills.
  • Critical-thinking and analytical problem-solving abilities.
  • Project management skills with knowledge of management tools/processes.
  • Effective communication skills, both verbal and written.
  • Proficient in Microsoft Office, especially Excel.

Responsibilities

  • Perform pre and post-delegation assessments and annual audits for compliance.
  • Monitor post-audit activities for adherence to NCQA, state, and federal requirements.
  • Prepare status reports from delegated entities and ensure reporting compliance.
  • Evaluate compliance scorecards and delegate performance metrics monthly.
  • Develop and document corrective action plans for identified compliance issues.
  • Assist in the preparation of oversight committee documents for delegated functions.
  • Work with the network management team to maintain delegation agreements and profiles.

Benefits

  • Comprehensive health insurance coverage.
  • Retirement savings plan with employer match.
  • Generous paid time off and holiday schedule.
  • Professional development opportunities.
  • Flexible work arrangements and environments.
Full Job Description
Job Description

JOB DESCRIPTION Job Summary
Provides senior level support for delegation oversight activities. Oversees delegated activities to ensure compliance with state, federal, contractual, National Committee for Quality Assurance (NCQA), and Molina requirements.

Essential Job Duties
• Under general leadership supervision, performs pre and post-delegation assessments and annual credentialing audits and monitoring of delegated activities to ensure compliance with NCQA, state and federal requirements.
• Monitors post-audit delegated activities to ensure compliance with state health plan and NCQA requirements.
• Prepares status reports from delegated entities.
• Ensures compliance with reporting requirements by tracking the receipt and completeness of reports.
• Evaluates monthly scorecards to monitor compliance of delegation oversight activities and delegate performance metrics.
• Develops corrective action plans (CAPs) when compliance issues are identified, and documents follow-up to completion.
• Assists in the preparation of the delegation oversight committee, including the preparation of documents for committee oversight of delegated functions.
• Assists in preparation of delegate profiles and works with the network management team to develop and maintain delegation agreements and assessment tools.
• Assists in preparation of delegation oversight document evidence for state monitoring visits and NCQA accreditation surveys.
• Provides training and support to new and existing delegation oversight team members.

Required Qualifications
• At least 3 years of managed care experience, year experience completing delegation oversight assessment/ audits, or equivalent combination of relevant education and experience.
• Data analysis experience.
• Ability to work independently or in a team, support multiple projects at once, and perform other duties or special projects as required.
• Ability to collaborate cross-functionally across a highly matrixed organization.
• Attention to detail and organizational skills.
• Critical-thinking, and problem-solving/analytical abilities.
• Project management skills/knowledge of project management tools/processes.
• Effective interpersonal and verbal/written communication skills.
• Microsoft Office suite proficiency (including Excel), and ability to learn/navigate new software programs.

Preferred Qualifications
• Quality management/regulatory/delegation oversight/auditing experience with increasing responsibility.

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.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals.

Molina Healthcare Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ

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