Delegation Oversight Coordinator
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Job Description
Delegation Oversight Coordinator managing reporting processes and monitoring delegated entities for HCSC. Ensuring compliance with regulatory standards and conducting financial audits for assigned products and business lines.
Responsibilities:
- Responsible for creating, managing and reporting processes designed to monitor and evaluate activities and functions delegated to contracted, delegated entities and vendors for assigned products and business lines
- Monitor timeliness of all claims, accuracy of payments and denial ratios
- Conduct quarterly and annual financial accuracy audits
Requirements:
- Bachelor's degree in Business or Medical OR 4 or more years' experience in a managed care environment
- 4 years in a leadership role that includes direct accountability and responsibility and direction of staff
- 4 years’ experience in directly performing delegated oversight activities
- Project Management skills and experience
- Knowledge of regulatory/accreditation requirements and standards (TDI, NCQA, URAC)
- Verbal and written communication skills
- Organizational skills and the ability to handle multiple priorities
- PC proficiency to include Word, Excel, PowerPoint and Lotus Notes
- Ability to travel
Benefits:
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
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