Delegation Oversight
- Coordinates, conducts, and documents delegation assessments as necessary to comply with state, federal, NCQA, and any other applicable requirements.
- Develops format and documents periodic status reports from Delegated Entities.
- Develops corrective action plans when deficiencies are identified, and documents follow-up to completion.
- Ensures delegated entity’s compliance with reporting requirements by tracking the receipt and completeness of reports.
- Develops corrective action plans when compliance issues are identified, and document follow-up to completion
- Must be RN or LVN
- Bachelor’s degree in related field or equivalent experience
- Familiarity with physician referrals, medical decision-making, working in a clinical environment, compliance practices
- 1+ years clinical experience as RN
- 8-10 years managed care experience
- Extensive knowledge of MS Word/Excel/Access
- Knowledge of NCQA and HEDIS standards and applicable state and federal laws
Hours: Monday-Friday 8:00am to 5:00pm, no OT, nights, no weekend or travel
Pay rate: $30-$37/hr
Interested in being considered?
If you are interested in applying to this position, please contact Jeff St Louis at 407-478-0332x223 and click the Green I’m Interested Button to email your resume.