Delegation Oversight Coordinator

Job Summary

A company is looking for a Senior Delegation Oversight Coordinator to manage delegation oversight and ensure compliance with credentialing standards.

Key Responsibilities

• Lead and participate in delegation oversight audits and ensure compliance with regulatory requirements
• Review and negotiate delegation agreements and manage provider data integrity and reporting
• Act as a liaison between internal departments and external health plan partners to resolve compliance issues

Required Qualifications

• Bachelor's Degree in Healthcare Administration, Business, or related field preferred
• 3-5 years of experience in Delegation Oversight, Credentialing, Managed Care, or Health Plan auditing
• Strong knowledge of credentialing standards from NCQA, URAC, CMS, and State regulations
• Experience with national and regional payors and managed care contracting structures
• Proficiency in contract review and negotiation with an understanding of delegated credentialing frameworks