Sr. Specialist, Delegation Oversight (Remote)
Molina Healthcare Arizona; Idaho; Michigan; Scottsdale, Arizona; Orlando, Florida; Nebraska; Albuquerque, New Mexico; New York, New York; Sioux City, Iowa; Caldwell, Idaho; Columbus, Ohio; Dallas, Texas; Layton, Utah; Boise, Idaho; Ann Arbor, Michigan; Tampa, Florida; Warren, Michigan; Omaha, Nebraska; Miami, Florida; Las Cruces, New Mexico; Cleveland, Ohio; Ohio; Austin, Texas; Orem, Utah; West Valley City, Utah; Wisconsin; Bowling Green, Kentucky; Detroit, Michigan; Kearney, Nebraska; Jacksonville, Florida; Florida; Columbus, Georgia; Syracuse, New York; Fort Worth, Texas; Vancouver, Washington; Seattle, Washington; Lexington-Fayette, Kentucky; Tucson, Arizona; Lincoln, Nebraska; St. Petersburg, Florida; Rochester, New York; Madison, Wisconsin; Idaho Falls, Idaho; Kentucky; Phoenix, Arizona; Buffalo, New York; New York; Iowa City, Iowa; Dayton, Ohio; Akron, Ohio; Utah; Spokane, Washington; Milwaukee, Wisconsin; Green Bay, Wisconsin; Owensboro, Kentucky; Louisville, Kentucky; Sterling Heights, Michigan; Grand Island, Nebraska; Augusta, Georgia; Atlanta, Georgia; Savannah, Georgia; Cedar Rapids, Iowa; Cincinnati, Ohio; San Antonio, Texas; Provo, Utah; Washington; Kenosha, Wisconsin; Racine, Wisconsin; Mesa, Arizona; Bellevue, Nebraska; Macon, Georgia; Georgia; Roswell, New Mexico; Iowa; Yonkers, New York; Meridian, Idaho; Texas; Houston, Texas; Bellevue, Washington; Nampa, Idaho; Covington, Kentucky; Grand Rapids, Michigan; Chandler, Arizona; Santa Fe, New Mexico; New Mexico; Rio Rancho, New Mexico; Des Moines, Iowa; Davenport, Iowa; Salt Lake City, Utah; Tacoma, Washington Job ID 2030527JOB DESCRIPTION
Job Summary
Responsible 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.
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: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 03/13/2025ABOUT OUR LOCATION
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