Delegation Oversight Specialist

Location: Coumbus, OH, United States
Position Purpose: Monitor and evaluate the performance of national delegated vendors according to CMS, and NCQA, Federal and State requirements. 
  • Manage and monitor vendors against CMS, contractual, Federal, State, and NCQA requirements
  • Review delegate’s documented process against contractual, state, federal, and NCQA requirements.
  • Develop and manage quality improvement and corrective action plans based on audit findings and vendor performance and communicate results
  • Coordinate and perform on-going monitoring of vendor activities to ensure compliance and deficiencies are identified
  • Collaborate with the health plans to ensure optimal management of the vendors
  • Perform process reviews of vendor audits of each entity to monitor progress on performance improvements
  • Facilitate Joint Oversight Committee meetings with internal and external partners, document discussions and action items
  • 30% travel required

Qualifications:
Education/Experience:
  • Bachelor’s degree in related field or equivalent experience.
  • 2+ years of quality management or vendor oversight experience.
Tami Andrade Fitzpatrick
Senior Recruiter
720-845-6562
tami@proenlist.com
www.proenlist.com


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