TITLE: DELEGATION OVERSIGHT SPECIALIST
DURATION: 6-12 MONTHS TO START
TRAVEL REQUIREMENTS: REMOTE TO START, THEN IDEALLY NEW YORK, NY
In this position,
The Delegation Oversight Specialist is responsible for ensuring all delegated activities are performed in accordance with company policy and contract requirements.
WHAT YOU'LL DO:
- Coordinates all Delegated Oversight Committee (DOC) activities, which serves as a forum to report and monitor performance of all delegated entities
- Prepares materials for the DOC and ensures all minutes and agendas are kept and distributed accordingly
- Reports findings and outcomes from the DOC to governing committees and Senior Management
- Coordinates all pre-delegated and annual audits, including mailing pre-audit letters/audit tools, scheduling audits, accurately completing delegation audit tool, reporting outcomes to the DOC, and required follow-up
- Monitors post-audit delegated activities to ensure compliance with all established state, federal, NCQA, and client requirements including tracking receipt of and monitoring monthly reports from delegated entities and assisting with development and implementation of Corrective Action Plans as non-compliant issues are identified Maintains a database of all reports from delegated entities
- Creates monthly scorecards to monitor compliance of Delegation Oversight activities and delegate performance metrics
- Identifies deficiencies and recommends solutions to support the implementation of updated or new regulatory standards and ensures full compliance with vendor contract requirements
- Assists in the performance of risk assessments for each delegated entity, and ensures reporting, monitoring, and audits capture the review of the risks identified
- Contributes to the achievement of established department goals and objectives and adheres to department and company's policies, procedures, and other standards
YOU'LL BE SUCCESSFUL IF:
- Self-starter with excellent interpersonal skills
- Solid understanding of the health care industry and Provider Relations.
- Excellent communication skills, written, verbal, and presentation
- Outstanding detail orientation Ability to multi-task, coupled with strong project management skills
- Proficiency in Microsoft Office (Word, Excel, Outlook, and PowerPoint)
- Excellent analytical and critical thinking skills
- Strong knowledge of Medicare, Medicaid, regulatory and medical management operations
- Ability to comprehend and interpret regulatory, legislative, and contractual mandates
WHAT YOU'LL BRING:
- Bachelor's degree in a health-related field; or equivalent work experience
- 3+ years of experience, Delegation Oversight, and/or Healthcare Compliance
ABOUT IMPRESIV HEALTH:
Impresiv Health is a healthcare consulting and staffing partner specializing in operations management consulting and business optimization services for companies across the healthcare continuum. Started on the belief that a firm's foundation could be built with a team of thought leaders and proven industry experts, we've established a company that delivers quick and efficient results for our clients.
We offer strategic business and technical management consulting services, and a suite of staffing solutions.
Impresiv Health is a services partner with a focus on expediting time-to-value. It's not just our goal to immediately deliver greater returns on your investment in us as a partner—it's our reputation.
QUICKER, EFFICIENT, AND AFFORDABLE. THAT'S IMPRESIV!