• National Manager, Delegation Oversight

    Molina Healthcare (UT)


    Job Description

    Job Summary

    Manages and leads the oversight of national and state delegated activities, ensuring compliance with State, Federal, NCQA and Molina delegation standards and requirements. Provides delegation oversight compliance leadership and expertise and responsible for the execution of the Delegation Oversight Program in full support of and extension of Molina’s Corporate Compliance Program. Collaborates closely with internal business owners to manage and administer the relationships for delegated entities including participating in on-boarding activities, management of delegation oversight activities including audits, corrective action plans, annual risk assessment for identification of complex delegate relationships, escalating as necessary delegate services issues, and performing ongoing risk monitoring.

    Job Duties

    + Oversees and manages the day-to-day operations of the Delegation Oversight Program of complex, multi-delegated, high-risk national and state delegates.

    + Leads and guides a multi-disciplinary delegation team including hiring, training, and evaluating performance of duties.

    + Creates, manages, and negotiates delegated services agreements with national and state delegates.

    + Coordinates, evaluates, and reviews delegation audit assessment tools as necessary to comply with state, federal, NCQA, and any other applicable requirements.

    + Assists with chairing monthly meetings of the National and/or Regional Delegation Oversight Committees, including review of agendas and meeting minutes, and documents for committee oversight of delegated functions.

    + Reports on Delegation Oversight activities to Quality Improvement and Corporate Compliance Committees as applicable.

    + Manages department processes to monitor the audit and monitoring performance of delegated entities on a regular interval and assigns corrective action plans when deficiencies are identified.

    + Prepares delegation oversight document evidence for federal and state monitoring visits and NCQA accreditation surveys and participates on Molina's work team (as applicable).

    + Designs and implements additions to delegation program to build/improve positive relationship with delegates.

    + Prepare performance reports for presentation to Senior Management.

    + Ensure all staff complete Molina required training timely.

    + Provides cross-training of staff for multi-functional auditor team structure

    Job Qualifications

    Required Qualifications

    + At least 8 years’ experience in delegation oversight, vendor oversight, auditing, compliance; at least 1 year experience in leading/supervising a team, or equivalent combination of relevant education and experience.

    + Advanced knowledge of Microsoft Office (Word, Excel PowerPoint and Access).

    + Knowledge of applicable state and federal law; National Committee for Quality Assurance (NCQA) standards.

    + Ability to independently manage multiple tasks or projects simultaneously to successful completion and is self-motivated.

    + Ability to work effectively on a team.

    + Excellent interpersonal, verbal, and written communication skills.

     

    To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

     

    Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

    Pay Range: $88,453 - $206,981 / ANNUAL

    *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.