Senior Specialist, Delegation Oversight
At Molina Healthcare, we are committed to providing high-quality, affordable healthcare services to our members. As a Senior Specialist, Delegation Oversight, you will play a crucial role in ensuring that our delegated entities comply with regulatory requirements and maintain the highest standards of care. We are seeking an experienced and dedicated professional who is passionate about promoting effective oversight and accountability within our organization. With your expertise and leadership, we can continue to deliver exceptional care to our members and uphold our commitment to excellence.
- Oversee and manage all aspects of delegated entity performance, ensuring compliance with regulatory requirements.
- Develop and implement processes for monitoring, auditing, and reporting on delegated entities' performance.
- Collaborate with internal and external stakeholders to establish and maintain strong relationships with delegated entities.
- Conduct thorough evaluations of delegated entities' operations, identifying areas for improvement and implementing corrective action plans.
- Stay current on changes in regulatory requirements and communicate updates to relevant parties.
- Provide guidance and support to delegated entities to help them achieve and maintain compliance.
- Analyze data and trends to identify potential risks and make recommendations for improvement.
- Develop and maintain policies and procedures related to delegated entity oversight.
- Serve as a subject matter expert on delegation oversight and provide training to internal teams.
- Lead and mentor a team of delegation oversight specialists, providing guidance and support in their day-to-day activities.
- Participate in cross-functional initiatives to improve the overall quality of care and services provided to members.
- Collaborate with other departments, such as Quality Improvement and Provider Relations, to ensure alignment and consistency in delegated entity oversight.
- Communicate effectively with senior leadership, presenting findings and recommendations for improvement.
- Foster a culture of accountability and continuous improvement within the organization.
- Represent the organization in external meetings and conferences related to delegated entity oversight.
Extensive Experience In Healthcare Operations: The Senior Specialist Should Have A Deep Understanding Of The Healthcare Industry And Its Complexities, Particularly In Managed Care. This Includes Knowledge Of Regulatory Requirements, Provider Networks, Claims Processing, And Quality Assurance.
Strong Knowledge Of Delegation Oversight: The Senior Specialist Should Have A Solid Understanding Of Delegation Oversight Processes And Best Practices. This Includes Knowledge Of Monitoring And Auditing Procedures, As Well As Experience In Identifying And Mitigating Compliance Risks.
Excellent Communication And Interpersonal Skills: As A Senior Specialist, The Ability To Communicate Effectively With Both Internal And External Stakeholders Is Crucial. This Includes Excellent Written And Verbal Communication Skills, As Well As The Ability To Build And Maintain Relationships With Providers, Regulatory Agencies, And Other Key Stakeholders.
Analytical And Problem-Solving Abilities: The Senior Specialist Must Have Strong Analytical Skills To Review And Analyze Complex Data, Identify Trends And Patterns, And Develop Effective Solutions To Address Any Issues That Arise. This Requires Attention To Detail, Critical Thinking, And The Ability To Make Well-Informed Decisions Based On Data Analysis.
Leadership And Project Management Experience: The Senior Specialist Will Be Responsible For Overseeing A Team Of Delegation Oversight Professionals And Ensuring That All Delegated Activities Are Compliant With Regulatory Requirements. Therefore, Previous Leadership Experience And Project Management Skills Are Essential To Effectively Manage And Develop A Team, Prioritize Tasks, And Meet Deadlines.
Quality Assurance
Data Analysis
Communication
Problem Solving
Team Leadership
Risk assessment
Performance monitoring
Program Evaluation
Regulatory compliance
Contract compliance
Relationship
Delegation Management
Communication
Conflict Resolution
Emotional Intelligence
Leadership
Problem Solving
Time management
creativity
Attention to detail
Teamwork
Adaptability
According to JobzMall, the average salary range for a Senior Specialist, Delegation Oversight in Los Angeles, CA, USA is $66,000-$110,000 per year. However, this can vary based on factors such as the specific industry, company size, and level of experience.
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Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.
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