Talent.com
LVN Delegation Oversight Nurse Remote
LVN Delegation Oversight Nurse RemoteMolina Healthcare • Macon, GA, US
LVN Delegation Oversight Nurse Remote

LVN Delegation Oversight Nurse Remote

Molina Healthcare • Macon, GA, US
1 day 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

  • 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 • Macon, GA, US

    Related jobs
    Travel Nurse RN - Telemetry - $1,881 per week in Warner Robins, GA

    Travel Nurse RN - Telemetry - $1,881 per week in Warner Robins, GA

    OneStaff Medical • Warner Robins, GA, US
    Full-time
    An independently-owned, nationally-recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by your side and help you find your...Show more
    Last updated: 1 day ago • Promoted
    Registered Nurse RN Home Health

    Registered Nurse RN Home Health

    Enhabit Home Health & Hospice • Warner Robins, GA, US
    Full-time
    Are you in search of a new career opportunity that makes a meaningful impact? If so, now is the time to find your calling at Enhabit Home Health & Hospice. As a national leader in home-based care, E...Show more
    Last updated: 1 day ago • Promoted
    LVN Delegation Oversight Nurse Remote

    LVN Delegation Oversight Nurse Remote

    Molina Healthcare • Macon, GA, US
    Remote
    Full-time
    The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities.Responsible for overseeing delegated activities to ensure compliance with the National Commit...Show more
    Last updated: 1 day ago • Promoted
    Travel Nurse RN - Telemetry - $2,400 per week

    Travel Nurse RN - Telemetry - $2,400 per week

    ProKatchers • Warner Robins, GA, US
    Full-time
    ProKatchers is seeking a travel nurse RN Telemetry for a travel nursing job in Warner Robins, Georgia.Job Description & Requirements. IV insertion, PICC lines, meditech charting.Pay package is based...Show more
    Last updated: 19 days ago • Promoted
    Travel Nurse RN - CVOR - $2,858 per week

    Travel Nurse RN - CVOR - $2,858 per week

    Binding Minds • Macon, GA, US
    Full-time
    Binding Minds is seeking a travel nurse RN CVOR for a travel nursing job in Macon, Georgia.Job Description & Requirements. Days – 4x10s (06 : 45AM – 5 : 15PM).BLS, ACLS, CNOR •, TNCC • ( •= Preferred).Bind...Show more
    Last updated: 13 days ago • Promoted
    Travel Nurse RN - Telemetry - $1,590 to $1,739 per week in Macon, GA

    Travel Nurse RN - Telemetry - $1,590 to $1,739 per week in Macon, GA

    TravelNurseSource • Macon, GA, US
    Full-time
    TravelNurseSource is working with Host Healthcare to find a qualified Telemetry RN in Macon, Georgia, 31201!.Host Healthcare is an award-winning travel healthcare company with an immediate opening ...Show more
    Last updated: 9 days ago • Promoted
    Travel Nurse RN - Telemetry in Warner Robins, GA

    Travel Nurse RN - Telemetry in Warner Robins, GA

    TNAA | TotalMed • Warner Robins, GA, US
    Full-time
    Travel Nurse Across America is seeking a qualified Telemetry RN needed for travel nurse assignment in Warner Robins, GA.This assignment is in a Traveler-friendly facility and offers excellent pay, ...Show more
    Last updated: 1 day ago • Promoted
    Travel Nurse RN - CVOR - $2,722 per week

    Travel Nurse RN - CVOR - $2,722 per week

    Nationwide Therapy Group • Macon, GA, US
    Full-time
    Nationwide Therapy Group is seeking a travel nurse RN CVOR for a travel nursing job in Macon, Georgia.Job Description & Requirements. RN / CVOR (Cardiovascular Operating Room).About Nationwide Thera...Show more
    Last updated: 17 days ago • Promoted
    Travel Nurse RN - Telemetry - $1,775 per week

    Travel Nurse RN - Telemetry - $1,775 per week

    Triage Staffing • Macon, GA, United States
    Full-time
    Triage Staffing is seeking a travel nurse RN Telemetry for a travel nursing job in Macon, Georgia.Job Description & Requirements. Travel Nursing : Telemetry Macon.Shift Details : 12H Days (12 : 00 AM-...Show more
    Last updated: 4 days ago • Promoted
    Travel CVOR Registered Nurse - $2,716 per week

    Travel CVOR Registered Nurse - $2,716 per week

    ADEX Healthcare Staffing LLC • Macon, GA, US
    Full-time
    ADEX Healthcare Staffing LLC is seeking a travel nurse RN CVOR for a travel nursing job in Macon, Georgia.Job Description & Requirements. Unit accepts first time travelers.Float required within faci...Show more
    Last updated: 16 days ago • Promoted
    Travel Nurse RN - OR - Operating Room - $2,150 per week

    Travel Nurse RN - OR - Operating Room - $2,150 per week

    Seven Healthcare • Macon, GA, US
    Full-time
    Seven Healthcare is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Macon, Georgia.Job Description & Requirements. Seven Healthcare is excited to offer an excellent travel ...Show more
    Last updated: 12 hours ago • Promoted • New!
    Travel Nurse RN - Telemetry - $1,515 to $1,680 per week in Warner Robins, GA

    Travel Nurse RN - Telemetry - $1,515 to $1,680 per week in Warner Robins, GA

    LRS Healthcare • Warner Robins, GA, US
    Full-time
    Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24 / 7 support, and a responsive, traveler-first culture. What are you waiting for? Apply today! Qualification...Show more
    Last updated: 1 day ago • Promoted
    Travel Nurse RN - OR - Operating Room - $1,960 per week

    Travel Nurse RN - OR - Operating Room - $1,960 per week

    Connected Health Care • Macon, GA, US
    Full-time +2
    Connected Health Care is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Macon, Georgia.Job Description & Requirements. Travel / Contract Operating Room Registered Nurse.Comp...Show more
    Last updated: 25 days ago • Promoted
    Travel Nurse RN - Telemetry - $2,021 to $2,227 per week in Warner Robins, GA

    Travel Nurse RN - Telemetry - $2,021 to $2,227 per week in Warner Robins, GA

    AMN Healthcare • Warner Robins, GA, US
    Full-time
    Job Description & Requirements Registered Nurse – Telemetry - Travel - (Tele RN) StartDate : 1 / 12 / 2026 Available Shifts : 12 N Pay Rate : $2020. This is a 237-bed acute care facility.We provide a wide ...Show more
    Last updated: 16 hours ago • Promoted • New!
    Travel Nurse RN - Telemetry - $2,257 per week in Warner Robins, GA

    Travel Nurse RN - Telemetry - $2,257 per week in Warner Robins, GA

    Olaro • Warner Robins, GA, US
    Full-time
    Description We are seeking a focused and compassionate Telemetry Nurse to join our progressive care team.In this vital role, you will care for patients who require continuous cardiac monitoring, of...Show more
    Last updated: 1 day ago • Promoted
    Travel Nurse RN - Telemetry - $2,006 per week

    Travel Nurse RN - Telemetry - $2,006 per week

    TNAA TotalMed RN • Warner Robins, GA, United States
    Permanent
    TNAA TotalMed RN is seeking a travel nurse RN Telemetry for a travel nursing job in Warner Robins, Georgia.Job Description & Requirements. We're looking for Telemetry RNs for an immediate travel nur...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Telemetry - $1,639 per week

    Travel Nurse RN - Telemetry - $1,639 per week

    Triage Staffing • Macon, GA, United States
    Full-time
    Triage Staffing is seeking a travel nurse RN Telemetry for a travel nursing job in Macon, Georgia.Job Description & Requirements. Travel Nursing : Telemetry Macon.Shift Details : 12H Days (12 : 00 AM-...Show more
    Last updated: 4 days ago • Promoted
    Travel Nurse RN - Telemetry - $2,200 per week

    Travel Nurse RN - Telemetry - $2,200 per week

    LanceSoft • Warner Robins, GA, US
    Full-time +1
    LanceSoft is seeking a travel nurse RN Telemetry for a travel nursing job in Warner Robins, Georgia.Job Description & Requirements. RN – Telemetry | Warner Robins, GA.IV insertion, PICC lines, Medit...Show more
    Last updated: 9 days ago • Promoted