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The Manager of Delegation Oversight for Health Plans will manage staff to assure HPN and Affiliated Groups are in compliance with Health Plan requirements. The Manager is also responsible to perform assigned projects to improve the efficiency or effectiveness of the department. The Manager will manage activities to meet health plan requirement in areas such as – routine reporting, ad hoc reporting, annual oversight audit preparation, annual audit oversight completion, response to CAPs, follow-up with medical groups to assure CAP implementation and compliance. Performs activities in order to promptly, efficiently, and accurately complete all health plan, state, federal and other regulatory compliance processes with minimal to moderate supervision. Develops strong and positive working relationship with Health Plan representatives. Has a strong command of regulatory and accrediting requirements and health plan requirements. Works closely with the Medical Groups, Data Analysts and Medical Group Delegation Oversight team to promote compliant UM and CM processes.
This position is Remote, however must reside in California.
Job Type: Full-time
Pay: $100,000.00 – $135,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Parental leave
- Vision insurance
Schedule:
- 8 hour shift
Work Location: Remote
