Talent.com
LVN Delegation Oversight Nurse Remote
LVN Delegation Oversight Nurse RemoteMolina Healthcare • Deltona, FL, US
LVN Delegation Oversight Nurse Remote

LVN Delegation Oversight Nurse Remote

Molina Healthcare • Deltona, FL, US
30+ 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 • Deltona, FL, US

    Related jobs
    LVN Delegation Oversight Nurse Remote

    LVN Delegation Oversight Nurse Remote

    Molina Healthcare • Clermont, FL, 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: 30+ days ago • Promoted
    OR Registered Nurse Part-Time

    OR Registered Nurse Part-Time

    AdventHealth New Smyrna Beach • New Smyrna Beach, FL, US
    Part-time
    All the benefits and perks you need for you and your family : .Student Loan Repayment Program.Whole Person Wellbeing Resources. Joining AdventHealth is about being part of something bigger.Its about b...Show more
    Last updated: 3 days ago • Promoted
    RN Registered Nurse Orthopedic Network Integrity Navigator

    RN Registered Nurse Orthopedic Network Integrity Navigator

    AdventHealth University • Orlando, FL, United States
    Full-time
    Orthopedic Network Integrity Navigator with Orthopedic Experience.All the benefits and perks you need for you and your family : . Debt-free Education (Certifications and Degrees without out-of-pocket ...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Telemetry - $2,010 per week

    Travel Nurse RN - Telemetry - $2,010 per week

    HealthTrust Workforce Solutions HCA • Lake Monroe, FL, US
    Full-time
    HealthTrust Workforce Solutions HCA is seeking a travel nurse RN Telemetry for a travel nursing job in Sanford, Florida.Job Description & Requirements Specialty : Telemetry Discipline : RN Start Date...Show more
    Last updated: 3 days ago • Promoted
    Travel Nurse RN - Telemetry - $2,649 per week

    Travel Nurse RN - Telemetry - $2,649 per week

    HealthTrust Workforce Solutions HCA • Sanford, FL, United States
    Full-time
    HealthTrust Workforce Solutions HCA is seeking a travel nurse RN Telemetry for a travel nursing job in Sanford, Florida.Job Description & Requirements. Requested Skill Set : An RN who provides patie...Show more
    Last updated: 3 days ago • Promoted
    OR Registered Nurse

    OR Registered Nurse

    AdventHealth Daytona Beach • Daytona Beach, Florida, United States
    Full-time
    All the benefits and perks you need for you and your family : \n \n\n \n\n \n.Benefits from Day One \n \n Paid Days Off from Day One \n \n Student Loan Repayment Program \n \n Career Development \n ...Show more
    Last updated: 11 days ago • Promoted
    Registered Nurse RN Inpatient Float Pool Nights

    Registered Nurse RN Inpatient Float Pool Nights

    AdventHealth Daytona Beach • Daytona Beach, FL, US
    Full-time
    All the benefits and perks you need for you and your family : .Up to $3,000 Relocation Assistance available to eligible candidates (see terms below). Benefits and Paid Days Off from Day One.Whole Pers...Show more
    Last updated: 1 day ago • Promoted
    Turn the page : lvn nursing career awaits

    Turn the page : lvn nursing career awaits

    Southern Health Partners • Lockhart, Florida, United States
    Full-time
    LVN Day Shift – Find Your Fresh Start with SHP!.Ready for a new beginning in nursing? At.Step into a role where your skills matter, your work makes a difference, and your employer invests in YOU.Da...Show more
    Last updated: 5 hours ago • Promoted • New!
    Travel Nurse RN - Telehealth - $1,400 per week

    Travel Nurse RN - Telehealth - $1,400 per week

    IDR Healthcare • Orlando, FL, USA
    Full-time
    IDR Healthcare is seeking a travel nurse RN Telehealth for a travel nursing job in Orlando, Florida.Job Description & Requirements. REMOTE RN providing specialized care in nephrology, palliative car...Show more
    Last updated: 30+ days ago • Promoted
    Nurse Manager RN

    Nurse Manager RN

    AdventHealth Daytona Beach • Daytona Beach, FL, US
    Full-time
    All the benefits and perks you need for you and your family : .Benefits and Paid Days Off from Day One.Whole Person Well-being and Mental Health Resources. Joining AdventHealth is about being part of ...Show more
    Last updated: 2 days ago • Promoted
    Rn / lpn nursing positions - weekends

    Rn / lpn nursing positions - weekends

    Southern Health Partners • Lockhart, Florida, United States
    Full-time
    LVN Day Shift – Find Your Fresh Start with SHP!.Ready for a new beginning in nursing? At.Step into a role where your skills matter, your work makes a difference, and your employer invests in YOU.Da...Show more
    Last updated: 5 hours ago • Promoted • New!
    Travel Nurse RN - OR - Operating Room

    Travel Nurse RN - OR - Operating Room

    GHR Healthcare • Orlando, FL, US
    Permanent
    GHR Healthcare is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Orlando, Florida.Job Description & Requirements. Travel Operating Room (OR) Tech Job – Orlando, ...Show more
    Last updated: 3 days ago • Promoted
    Registered Nurse RN Regional Float Pool Nights

    Registered Nurse RN Regional Float Pool Nights

    AdventHealth Daytona Beach • Orange City, FL, US
    Full-time
    All the benefits and perks you need for you and your family : .Benefits and Paid Days Off from Day One.Whole Person Well-being and Mental Health Resources. Joining AdventHealth is about being part of ...Show more
    Last updated: 30+ days ago • Promoted
    LVN Delegation Oversight Nurse Remote

    LVN Delegation Oversight Nurse Remote

    Molina Healthcare Careers • Orlando, FL, 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: 11 hours ago • Promoted • New!
    RN Registered Nurse MedSurg Telemetry FT Days

    RN Registered Nurse MedSurg Telemetry FT Days

    AdventHealth Lake Wales • Altamonte Springs, FL, US
    Full-time
    All the benefits and perks you need for you and your family : \n • Benefits from Day One\n • Paid Days Off from Day One\n • Debt-free Education (Certifications and Degrees without out-of-pocket tuition ...Show more
    Last updated: 11 hours ago • Promoted • New!
    Per Diem / PRN Nurse RN - Telemetry - $48 per hour

    Per Diem / PRN Nurse RN - Telemetry - $48 per hour

    HealthTrust Workforce Solutions • Orlando, FL, US
    Full-time
    HealthTrust Workforce Solutions Local is seeking a per diem / prn nurse RN Telemetry for a per diem / prn nursing job in Kissimmee, Florida. Job Description & Requirements.Entrust Your Career to...Show more
    Last updated: 11 hours ago • Promoted • New!
    Travel Nurse RN - OR - Operating Room - $2,500 per week

    Travel Nurse RN - OR - Operating Room - $2,500 per week

    Nightingale Nurses • Orlando, FL, US
    Full-time
    Nightingale Nurses - Allied is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Orlando, Florida. Job Description & Requirements.Show more
    Last updated: 11 hours ago • Promoted • New!
    Travel Nurse RN - Telemetry - $2,649 per week

    Travel Nurse RN - Telemetry - $2,649 per week

    HealthTrust Workforce Solutions • Sanford, FL, US
    Full-time
    HealthTrust Workforce Solutions HCA is seeking a travel nurse RN Telemetry for a travel nursing job in Sanford, Florida.Job Description & Requirements. Requested Skill Set : An RN who provides pa...Show more
    Last updated: 11 hours ago • Promoted • New!
    Registered Nurse RN Regional Float Pool

    Registered Nurse RN Regional Float Pool

    AdventHealth Daytona Beach • Daytona Beach, FL, US
    Full-time
    All the benefits and perks you need for you and your family : .Benefits and Paid Days Off from Day One.Whole Person Well-being and Mental Health Resources. Joining AdventHealth is about being part of ...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Long Term Acute Care

    Travel Nurse RN - Long Term Acute Care

    Genie Healthcare • Daytona Beach, FL, US
    Full-time
    Genie Healthcare is seeking a travel nurse RN Long Term Acute Care for a travel nursing job in Daytona Beach, Florida.Job Description & Requirements. Genie Healthcare is seeking a Registered Nur...Show more
    Last updated: 13 days ago • Promoted