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