Delegate Oversight Specialist

Job Summary

To ensure compliance and oversight of delegated entities, the full-time remote Delegate Oversight Specialist will conduct pre-delegation assessments, monitor performance against regulatory standards, and manage corrective action plans while collaborating with various internal teams.

Key responsibilities

• Conduct pre-delegation assessments and annual audits of delegated entities, ensuring adherence to regulatory and contractual requirements
• Lead audits of delegate operations, document findings, and develop corrective action plans for identified deficiencies
• Compile and submit delegation performance reports while maintaining organized, audit-ready documentation

Required qualifications

• Bachelor's degree in Healthcare Administration, Business, Nursing, or a related field; equivalent experience considered
• 3+ years of experience in health plan operations, managed care compliance, audit, or delegation oversight
• Demonstrated experience conducting audits and managing corrective action plans
• Strong organizational skills with the ability to manage multiple delegate relationships and deadlines