Provides senior level support for delegation oversight activities. Oversees delegated activities to ensure compliance with state, federal, contractual, National Committee for Quality Assurance (NCQA), and Molina requirements.
Essential Job Duties- Under general leadership supervision, performs pre and post-delegation assessments and annual credentialing audits and monitoring of delegated activities to ensure compliance with NCQA, state and federal requirements.
• Monitors post-audit delegated activities to ensure compliance with state health plan and NCQA requirements.
• Prepares status reports from delegated entities.
• Ensures compliance with reporting requirements by tracking the receipt and completeness of reports.
• Evaluates monthly scorecards to monitor compliance of delegation oversight activities and delegate performance metrics.
• Develops corrective action plans (CAPs) when compliance issues are identified, and documents follow-up to completion.
• Assists in the preparation of the delegation oversight committee, including the preparation of documents for committee oversight of delegated functions.
• Assists in preparation of delegate profiles and works with the network management team to develop and maintain delegation agreements and assessment tools.
• Assists in preparation of delegation oversight document evidence for state monitoring visits and NCQA accreditation surveys.
• Provides training and support to new and existing delegation oversight team members.
Required Qualifications
- At least 3 years of managed care experience, year experience completing delegation oversight assessment/ audits, or equivalent combination of relevant education and experience.
• Data analysis experience.
- Ability to work independently or in a team, support multiple projects at once, and perform other duties or special projects as required.
• Ability to collaborate cross-functionally across a highly matrixed organization.
• Attention to detail and organizational skills.
• Critical-thinking, and problem-solving/analytical abilities.
• Project management skills/knowledge of project management tools/processes.
• Effective interpersonal and verbal/written communication skills.
• Microsoft Office suite proficiency (including Excel), and ability to learn/navigate new software programs.
Preferred Qualifications
- Quality management/regulatory/delegation oversight/auditing experience with increasing responsibility.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
offers a competitive benefits and compensation package. is an Equal Opportunity Employer (EOE) M/F/D/V
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