***Remote and must live in the United States***
JOB DESCRIPTION
Job Summary
Leads and manages a regional team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements. Collaborates closely with internal business owners to manage and administer the relationships and performance of delegated entities including health plan onboarding and offboarding activities, management of oversight activities, audits and corrective action plans, issuance and service issue escalations, and ongoing risk monitoring.
Essential Job Duties
• Oversees and manages the day-to-day operations of the delegation oversight program for assigned states and respective state delegates within a designated region.
• Chairs monthly meetings of region and/or state (where contractually required with the state regulator) delegation oversight committee, including review of agendas and meeting minutes, and documents for committee oversight of delegated functions.
• Coordinates, evaluates, and reviews delegation audit assessment tools as necessary to comply with state, federal, National Committee for Quality Assurance (NCQA), and any other applicable requirements.
• Manages department processes, monitors performance of delegated entities on regulars intervals, and assigns corrective action plans (CAPs) when deficiencies are identified.
• Prepares delegation oversight document evidence for state regulatory audits.
• Collaborates with national delegation oversight senior leadership in the development of new and updates to existing delegation audit tools and policies/procedures.
• Prepares delegation oversight performance reports for presentation to health plans and senior leadership.
• Hires, trains, mentors, develops, and manages delegation oversight team, and demonstrates accountability for team performance.
Required Qualifications
• At least 7 years of related auditing/vendor/data management experience, preferably in delegation oversight, or equivalent combination of relevant education and experience.
• At least 1 year management/leadership experience.
• Ability to build relationships and manage a team.
• Strong critical-thinking and problem-solving/analytical abilities.
• Strong time-management, organizational, detail orientation and prioritization skills.
• Strong project management skills and knowledge of project management tools/processes.
• Strong data processing/analysis experience.
• Ability to interpret error reports and identify remediation steps.
• Ability to collaborate cross-functionally across a highly matrixed organization.
• Strong interpersonal and verbal/written communication skills.
• Microsoft Office suite proficiency (including Excel), and ability to learn/navigate new software programs.
Preferred Qualifications
• Delegation oversight experience.
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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. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Job details are sourced from the employer's original posting.
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Molina Talent Acquisition is the recruiting arm of Molina Healthcare, focused on finding and hiring talent for the organization.