Talent.com
LVN Delegation Oversight Nurse Remote
LVN Delegation Oversight Nurse RemoteMolina Healthcare • Adero Az, NM, US
No longer accepting applications
LVN Delegation Oversight Nurse Remote

LVN Delegation Oversight Nurse Remote

Molina Healthcare • Adero Az, NM, 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

  • 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 • Adero Az, NM, US

    Related jobs
    RN - Endoscopy - As Needed

    RN - Endoscopy - As Needed

    Monument Health • Santa Rosa, NM, US
    Full-time
    Current Employees : \n\nIf you are a current employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.Primary...Show more
    Last updated: 1 day ago • Promoted
    Entry-Level Border Patrol Agent – $30,000 Sign-On Bonus

    Entry-Level Border Patrol Agent – $30,000 Sign-On Bonus

    United States Customs and Border Protection • El Ancon, NM, United States
    Full-time
    IMPORTANT NOTICE : Duty assignments available at time of offer may include the Southwest Border including prioritized locations. Border Patrol determines duty assignments at time of offer based on op...Show more
    Last updated: 30+ days ago • Promoted
    Online Survey Taker. Earn up to $25 per survey. - Remote

    Online Survey Taker. Earn up to $25 per survey. - Remote

    Earn Haus • Santa Rosa, New Mexico, US
    Remote
    Full-time +1
    We are urgently looking for people interested in taking online surveys for Fortune 500 brands.If you are a self-starter, looking for flexible hours throughout the week, this may be for you! Earn up...Show more
    Last updated: 30+ days ago • Promoted
    Border Patrol Agent (Entry Level) – Up to $30,000 Hiring Bonus

    Border Patrol Agent (Entry Level) – Up to $30,000 Hiring Bonus

    United States Customs and Border Protection • Puerta De Luna, NM, United States
    Full-time
    IMPORTANT NOTICE : Duty assignments available at time of offer may include the Southwest Border including prioritized locations. Border Patrol determines duty assignments at time of offer based on op...Show more
    Last updated: 30+ days ago • Promoted
    Naval Pilot

    Naval Pilot

    US Navy Reserve • Santa Rosa, NM, United States
    Part-time
    ABOUT Pursuing a civilian career doesn’t have to mean getting stuck in the corporate world.As a current or former Naval Aviator, there are plenty of part-time opportunities to use your leadership s...Show more
    Last updated: 4 days ago • Promoted
    Naval Flight Officer

    Naval Flight Officer

    US Navy Reserve • Santa Rosa, NM, United States
    Part-time
    ABOUT Pursuing a civilian career doesn’t have to mean getting stuck in the corporate world.As a current or former Naval Flight Officer, there are plenty of part-time opportunities to use your leade...Show more
    Last updated: 4 days ago • Promoted
    Part-Time Surface Officer

    Part-Time Surface Officer

    US Navy Reserve • Santa Rosa, NM, United States
    Part-time
    ABOUT Pursuing a civilian career doesn’t have to mean getting stuck in the corporate world.As a current or former Navy Surface Warfare Officer, there are plenty of part-time opportunities to use yo...Show more
    Last updated: 4 days ago • Promoted
    Border Patrol Agent – Law Enforcement Career, $30,000 Recruitment Incentive

    Border Patrol Agent – Law Enforcement Career, $30,000 Recruitment Incentive

    United States Customs and Border Protection • El Ancon, NM, United States
    Full-time
    IMPORTANT NOTICE : Duty assignments available at time of offer may include the Southwest Border including prioritized locations. Border Patrol determines duty assignments at time of offer based on op...Show more
    Last updated: 30+ days ago • Promoted
    Submarine Warfare Officer

    Submarine Warfare Officer

    US Navy Reserve • Santa Rosa, NM, United States
    Part-time
    ABOUT Pursuing a civilian career doesn’t have to mean getting stuck in the corporate world.As a current or former Navy Submarine Warfare Officer, there are plenty of part-time opportunities to use ...Show more
    Last updated: 4 days ago • Promoted
    Part-Time Navy Reserve Pilot

    Part-Time Navy Reserve Pilot

    US Navy Reserve • Santa Rosa, NM, United States
    Part-time
    ABOUT Pursuing a civilian career doesn’t have to mean getting stuck in the corporate world.As a current or former Naval Aviator, there are plenty of part-time opportunities to use your leadership s...Show more
    Last updated: 4 days ago • Promoted
    LPN / LVN - Correctional

    LPN / LVN - Correctional

    Staff Today • Santa Rosa, NM, US
    Full-time
    Staff Today is seeking a LPN / LVN Correctional for a travel job in Santa Rosa, New Mexico.Job Description & Requirements. Health Advocates Network is currently seeking a.Weekly Gross Pay ($20 p...Show more
    Last updated: 11 days ago • Promoted
    LPN / LVN - Correctional - $1,630 per week - Urgently Hiring

    LPN / LVN - Correctional - $1,630 per week - Urgently Hiring

    Staff Today • Santa Rosa, NM, United States
    Full-time
    Staff Today is seeking a LPN / LVN Correctional for a travel job in Santa Rosa, New Mexico.Job Description & Requirements. Health Advocates Network is currently seeking a.Weekly Gross Pay ($20 per h...Show more
    Last updated: 12 days ago • Promoted
    Work from Home

    Work from Home

    Earn Haus • Santa Rosa, NM, United States
    Remote
    Full-time +1
    We are urgently looking for people interested in taking online surveys for Fortune 500 brands.If you are a self-starter, looking for flexible hours throughout the week, this may be for you! Earn up...Show more
    Last updated: 30+ days ago • Promoted
    Surface Warfare Officer

    Surface Warfare Officer

    US Navy Reserve • Santa Rosa, NM, United States
    Part-time
    ABOUT Pursuing a civilian career doesn’t have to mean getting stuck in the corporate world.As a current or former Navy Surface Warfare Officer, there are plenty of part-time opportunities to use yo...Show more
    Last updated: 4 days ago • Promoted
    Travel Outpatient Physical Therapist

    Travel Outpatient Physical Therapist

    Synergy Medical Staffing • Santa Rosa, NM, US
    Permanent
    Synergy Medical Staffing is seeking a travel Outpatient Physical Therapist for a travel job in Santa Rosa, New Mexico.Job Description & Requirements. Location : Santa Rosa, New Mexico.Shift : 5x8 ...Show more
    Last updated: 30+ days ago • Promoted
    Travel Outpatient Physical Therapist - $2,146 per week

    Travel Outpatient Physical Therapist - $2,146 per week

    Synergy Medical Staffing • Santa Rosa, NM, United States
    Permanent
    Synergy Medical Staffing is seeking a travel Outpatient Physical Therapist for a travel job in Santa Rosa, New Mexico.Job Description & Requirements. Location : Santa Rosa, New Mexico.Shift : 5x8 Days...Show more
    Last updated: 28 days ago • Promoted
    RN - Gastroenterology

    RN - Gastroenterology

    Monument Health • Santa Rosa, NM, US
    Full-time
    Current Employees : \n\nIf you are a current employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.Primary...Show more
    Last updated: 15 hours ago • Promoted • New!
    Experienced Border Patrol Agent - Up to $30,000 Recruitment Incentive

    Experienced Border Patrol Agent - Up to $30,000 Recruitment Incentive

    United States Customs and Border Protection • Santa Rosa, NM, US
    Full-time
    Border Patrol Agent - Experienced (GS11) Check out this higher-salaried federal law enforcement opportunity with U.Your current or prior law enforcement experience may qualify you for this career o...Show more
    Last updated: 11 hours ago • Promoted • New!
    Border Patrol Agent - Experienced (GS11)

    Border Patrol Agent - Experienced (GS11)

    United States Customs and Border Protection • Bell Ranch, NM, US
    Full-time
    Border Patrol Agent - Experienced (GS11) Check out this higher-salaried federal law enforcement opportunity with U.Your current or prior law enforcement experience may qualify you for this career o...Show more
    Last updated: 25 days ago • Promoted
    Border Patrol Agent

    Border Patrol Agent

    United States Customs and Border Protection • El Ancon, NM, United States
    Full-time
    IMPORTANT NOTICE : Duty assignments available at time of offer may include the Southwest Border including prioritized locations. Border Patrol determines duty assignments at time of offer based on op...Show more
    Last updated: 30+ days ago • Promoted