Talent.com
LVN Delegation Oversight Nurse Remote
LVN Delegation Oversight Nurse RemoteMolina Healthcare Careers • RIO RANCHO, NM, United States
No longer accepting applications
LVN Delegation Oversight Nurse Remote

LVN Delegation Oversight Nurse Remote

Molina Healthcare Careers • RIO RANCHO, NM, United States
5 days ago
Job type
  • Full-time
  • Remote
Job description

JOB DESCRIPTION

Job Summary

The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for overseeing delegated activities to ensure compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and requirements pertaining to delegation agreements. Contributes to overarching strategy to provide quality and cost-effective member care.

This position will support our Corporate Compliance business. The candidate must have an unrestricted LVN licensure. Candidates must be technologically proficient, self-directed, autonomous and experience working from home. Care Management & Waiver Service Auditing experience is highly preferred.

Work hours : Monday - Friday 8 : 00am – 4 : 00pm

Remote position

Essential Job Duties

  • Coordinates, conducts and documents pre-delegation and annual assessments as necessary to comply with state, federal and National Committee for Quality Assurance (NCQA) guidelines, and other applicable requirements.
  • Distributes audit results letters, follow-up letters, audit tools and annual reporting requirement as needed.
  • Works with delegation oversight analytics representatives on monitoring performance reports from delegated entities.
  • Develops corrective action plans (CAPs) when deficiencies are identified, and documents follow-up to completion.

Assists with delegation oversight committee meetings.

  • Works with delegation oversight leadership to develop and maintain delegation assessment tools, policies and reporting templates.
  • Assists with preparation of delegation summary reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and / or utilization management committees.
  • Participates as needed in joint operation committees (JOCs) for delegated groups.
  • Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid, National Committee for Quality Assurance (NCQA) and / or other regulatory audits as needed.
  • Required Qualifications

  • At least 3 years’ experience in health care, including 2 years’ experience in a managed care environment facilitating utilization reviews, or equivalent combination of relevant education and experience.
  • Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). The license must be active and unrestricted in state of practice.
  • Knowledge of audit processes and applicable state and federal regulations.
  • Ability to work effectively in a fast-paced, high-volume environment, maintain accuracy and meet established deadlines.
  • Ability to collaborate effectively with team members and internal departments.
  • Strong attention to detail with a focus on maintaining quality in all tasks.
  • Strong verbal and written communication skills.
  • Microsoft Office suite / applicable software program(s) proficiency.
  • Preferred Qualifications

  • Registered Nurse (RN). The license must be active and unrestricted in state of practice.
  • Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified Professional in Healthcare Quality (CPHQ).
  • To all current Molina employees : If you are interested in applying for this position, please apply through the Internal Job Board.

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

    Pay Range : $77,969 - $128,519 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • Create a job alert for this search

    Lvn Nurse • RIO RANCHO, NM, United States

    Related jobs
    Clinical Nurse (RN) Digestive Health / Full-Time

    Clinical Nurse (RN) Digestive Health / Full-Time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) Behavioral Health / Full-time

    Clinical Nurse (RN) Behavioral Health / Full-time

    CHRISTUS Health • White Rock, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) Oncology / Full-Time

    Clinical Nurse (RN) Oncology / Full-Time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) Womens' Services / Full-time

    Clinical Nurse (RN) Womens' Services / Full-time

    CHRISTUS Health • White Rock, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Nursing Surgical Charge Entry Specialist (RN) / OR / Full-time

    Nursing Surgical Charge Entry Specialist (RN) / OR / Full-time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    Nursing Surgical Charge Entry Specialist.Graduate of an accredited program for Registered Nursing.Specific knowledge of surgical procedures. Extensive communication skills.Registered Nurse with a mi...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) OR / FULL-TIME

    Clinical Nurse (RN) OR / FULL-TIME

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - L&D

    Travel Nurse RN - L&D

    Titan Medical Group • Albuquerque, NM, US
    Full-time
    WHEN YOU WORK FOR US, WE WORK FOR YOU\n.With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country. You also get unmatched service.From the moment y...Show more
    Last updated: 17 hours ago • Promoted • New!
    Clinical Nurse (RN) Medical Oncology / Full-Time

    Clinical Nurse (RN) Medical Oncology / Full-Time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) Digestive Health / Part-time

    Clinical Nurse (RN) Digestive Health / Part-time

    CHRISTUS Health • White Rock, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) ED Behavioral Health / Full-time

    Clinical Nurse (RN) ED Behavioral Health / Full-time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) OR Admitting / Full-Time

    Clinical Nurse (RN) OR Admitting / Full-Time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 18 days ago • Promoted
    Clinical Nurse (RN) Inpatient ORTHO / Per Diem

    Clinical Nurse (RN) Inpatient ORTHO / Per Diem

    CHRISTUS Health • White Rock, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse Manager (RN) Critical Care / Full-time

    Clinical Nurse Manager (RN) Critical Care / Full-time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    Is responsible for daily clinical operations of the Critical Care Unit, Telemetry.Coordinates all work and call scheduling efforts of the CVIR nurses. Is accountable for all orientation and training...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) OR / Full-Time

    Clinical Nurse (RN) OR / Full-Time

    CHRISTUS Health • White Rock, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) OR / Full-Time

    Clinical Nurse (RN) OR / Full-Time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - OR

    Travel Nurse RN - OR

    Titan Medical Group • Rio Rancho, NM, US
    Full-time
    WHEN YOU WORK FOR US, WE WORK FOR YOU\n.With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country. You also get unmatched service.From the moment y...Show more
    Last updated: 17 hours ago • Promoted • New!
    Clinical Nurse (RN) OR / Part-Time

    Clinical Nurse (RN) OR / Part-Time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Part-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Nurse (RN) Women's Services / Full-time

    Clinical Nurse (RN) Women's Services / Full-time

    CHRISTUS Health • Pena Blanca, New Mexico, United States
    Full-time
    The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient population served on the assigned units. He / she ensures that quality ca...Show more
    Last updated: 30+ days ago • Promoted