Sr Specialist, Delegation Oversight (Claims)- REMOTE - CA ONLY
Company: Molina Healthcare
Location: Long Beach
Posted on: November 26, 2022
JOB DESCRIPTIONJob SummaryResponsible for continuous quality
improvements within the Delegation Oversight Department. Oversees
delegated activities to ensure compliance primarily with DMHC and
DHCS requirements including delegation standards and requirements
contained in the Molina Medical Compliance and Fraud, Waste and
Abuse Program.This position is in California and is in
- Coordinates, conducts, and documents delegation assessments as
necessary to comply with state, federal, NCQA, and any other
- 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
- 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
- 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 QUALIFICATIONSRequired EducationBachelor's Degree or equivalent
combination of education and experience.Required Experience
- 3+ years managed care experience.
- Min. 1 year experience completing delegation oversight
- Data analysis experience.
Required License, Certification, AssociationValid State Driver's
LicensePreferred EducationBachelor's Degree in Business or Health
Care related field.Preferred Experience
- 5 years managed care experience.
- 2 years' experience completing delegation oversight
- Quality management/regulatory experience with increasing
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.#PJHPO -#Li-BeMorePay Range: -$45,390.49 -
$88,511.46 a year**Actual compensation may vary from posting based
on geographic location, work experience, education and/or skill
Keywords: Molina Healthcare, Long Beach , Sr Specialist, Delegation Oversight (Claims)- REMOTE - CA ONLY, Other , Long Beach, California
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