Talent.com
No longer accepting applications
LVN Delegation Oversight Nurse Remote

LVN Delegation Oversight Nurse Remote

Molina Healthcare CareersANN ARBOR, MI, United States
14 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

  • 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 • ANN ARBOR, MI, United States

    Related jobs
    • Promoted
    Travel CVOR Registered Nurse

    Travel CVOR Registered Nurse

    Nightingale NursesAnn Arbor, MI, US
    Full-time
    Nightingale Nurses is seeking a travel nurse RN CVOR for a travel nursing job in Ann Arbor, Michigan.Job Description & Requirements. You may not realize it, but as an RN with real world hospital...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - OR - Operating Room

    Travel Nurse RN - OR - Operating Room

    Trinity Health FirstChoiceAnn Arbor, MI, US
    Part-time
    Trinity Health FirstChoice is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Ann Arbor, Michigan. Job Description & Requirements.Location : Trinity Health Ann Arbor.Thi...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse - RN - TELE - Telemetry - $1583 / Week

    Travel Nurse - RN - TELE - Telemetry - $1583 / Week

    Medpro Healthcare StaffingCommerce Township, MI, US
    Full-time
    Medpro Healthcare Staffing is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Commerce Township, MI. Shift : 3x12 hr nights Start Date : 11 / 24 / 2025 Duration : 13...Show moreLast updated: 19 days ago
    • Promoted
    Travel Registered Nurse (RN) - Telemetry - $1,303 to $1,505 per week in Commerce Charter Township, MI

    Travel Registered Nurse (RN) - Telemetry - $1,303 to $1,505 per week in Commerce Charter Township, MI

    TravelNurseSourceCommerce Charter Township, MI, US
    Full-time
    TravelNurseSource is working with National Staffing Solutions to find a qualified Telemetry RN in Commerce Charter Township, Michigan, 48382!. Details of the RN - Telemetry (TELE) opening in Commerc...Show moreLast updated: 14 days ago
    • Promoted
    Travel Nurse - RN - TELE - Telemetry - $1521 / Week

    Travel Nurse - RN - TELE - Telemetry - $1521 / Week

    Uniti MedCommerce Township, MI, US
    Full-time
    Uniti Med is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Commerce Township, MI. Shift : Inquire Start Date : 11 / 17 / 2025 Duration : 5 weeks Pay : $1521 / Week....Show moreLast updated: 19 days ago
    • Promoted
    Travel Nurse RN - Telemetry

    Travel Nurse RN - Telemetry

    Arrow Healthcare Staffing48382, MI, US
    Full-time
    Arrow Healthcare Staffing is seeking a travel nurse RN Telemetry for a travel nursing job in Commerce Township, Michigan. Job Description & Requirements.Arrow Healthcare Staffing Job ID #1706624...Show moreLast updated: 19 days ago
    • Promoted
    Travel Nurse RN - Telemetry

    Travel Nurse RN - Telemetry

    Triage Staffing48382, MI, US
    Full-time
    Triage Staffing is seeking a travel nurse RN Telemetry for a travel nursing job in Commerce Township, Michigan.Job Description & Requirements. Travel Nursing : Telemetry Commerce Township.Locatio...Show moreLast updated: 19 days ago
    • Promoted
    Travel Nurse - Registered Nurse - TELE - Telemetry - $1583 / Week

    Travel Nurse - Registered Nurse - TELE - Telemetry - $1583 / Week

    Medpro Healthcare StaffingCommerce Township, MI, US
    Full-time
    Medpro Healthcare Staffing is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Commerce Township, MI. Shift : 3x12 hr nights Start Date : 11 / 24 / 2025 Duration : 13...Show moreLast updated: 19 days ago
    • Promoted
    Registered Nurse (RN) - Sign On Bonus

    Registered Nurse (RN) - Sign On Bonus

    The Manor of NoviNOVI, Michigan, United States
    Full-time +1
    Sign on Bonus : full time $8,000, part time 20hrs a week or more $4,000.Part and full time, 7am-7pm Available.Are you a critical thinker, a skilled communicator and passionate about caring fo...Show moreLast updated: 13 days ago
    • Promoted
    Travel Registered Nurse (RN) - Cardiovascular Operating Room (CVOR) - $3,037 per week in Ann Arbor, MI

    Travel Registered Nurse (RN) - Cardiovascular Operating Room (CVOR) - $3,037 per week in Ann Arbor, MI

    TravelNurseSourceAnn Arbor, MI, US
    Full-time
    TravelNurseSource is working with Triage Staffing to find a qualified CVOR RN in Ann Arbor, Michigan, 48103!.Travel Nursing : Cardiovascular OR Ann Arbor. Shift Details : 9H Days (6 : 30 AM-4 : 00 PM).L...Show moreLast updated: 14 days ago
    • Promoted
    Travel Nurse - Registered Nurse - TELE - Telemetry - $1489 / Week

    Travel Nurse - Registered Nurse - TELE - Telemetry - $1489 / Week

    Cynet HealthCommerce Township, MI, US
    Full-time
    Cynet Health is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Commerce Township, MI. Shift : 3x12 hr nights Start Date : 11 / 17 / 2025 Duration : 5 weeks Pay : $14...Show moreLast updated: 19 days ago
    • Promoted
    Travel Nurse - RN - TELE - Telemetry - $1583 / Week - Hiring Now

    Travel Nurse - RN - TELE - Telemetry - $1583 / Week - Hiring Now

    Medpro Healthcare StaffingCommerce Township, MI, US
    Full-time
    Medpro Healthcare Staffing is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Commerce Township, MI. Shift : 3x12 hr nights Start Date : 11 / 24 / 2025 Duration : 13...Show moreLast updated: 19 days ago
    • Promoted
    Travel Nurse - Registered Nurse - CVOR - Cardiovascular Operating Room - $2811.8 / Week

    Travel Nurse - Registered Nurse - CVOR - Cardiovascular Operating Room - $2811.8 / Week

    Atlas MedStaffAnn Arbor, MI, US
    Full-time
    Atlas MedStaff is seeking an experienced Cardiovascular Operating Room Registered Nurse for an exciting Travel Nursing job in Ann Arbor, MI. Shift : 4x10 hr flex Start Date : 12 / 08 / 2025 Duration : 13 w...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Telemetry Registered Nurse

    Travel Telemetry Registered Nurse

    AHS StaffingCommerce, MI, US
    Full-time
    AHS Staffing is seeking a travel nurse RN Telemetry for a travel nursing job in Commerce Charter Twp, Michigan.Job Description & Requirements. AHS Staffing is looking for a Telemetry Registered ...Show moreLast updated: 19 days ago
    • Promoted
    Travel Nurse - RN - TELE - Telemetry - $1489 / Week

    Travel Nurse - RN - TELE - Telemetry - $1489 / Week

    Cynet HealthCommerce Township, MI, US
    Full-time
    Cynet Health is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Commerce Township, MI. Shift : 3x12 hr nights Start Date : 11 / 17 / 2025 Duration : 5 weeks Pay : $14...Show moreLast updated: 19 days ago
    • Promoted
    Travel Nurse - RN - TELE - Telemetry - $1291.5 / Week

    Travel Nurse - RN - TELE - Telemetry - $1291.5 / Week

    Coast Medical ServiceCommerce Township, MI, US
    Full-time
    Coast Medical Service is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Commerce Township, MI. Shift : 3x12 hr nights Start Date : 11 / 17 / 2025 Duration : 5 weeks...Show moreLast updated: 19 days ago
    • Promoted
    Travel Nurse - RN - CVOR - Cardiovascular Operating Room - $2811.8 / Week - Hiring Now

    Travel Nurse - RN - CVOR - Cardiovascular Operating Room - $2811.8 / Week - Hiring Now

    Atlas MedStaffAnn Arbor, MI, US
    Full-time
    Atlas MedStaff is seeking an experienced Cardiovascular Operating Room Registered Nurse for an exciting Travel Nursing job in Ann Arbor, MI. Shift : 4x10 hr flex Start Date : 12 / 08 / 2025 Duration : 13 w...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse - RN - TELE - Telemetry - $1489 / Week - Hiring Now

    Travel Nurse - RN - TELE - Telemetry - $1489 / Week - Hiring Now

    Cynet HealthCommerce Township, MI, US
    Full-time
    Cynet Health is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Commerce Township, MI. Shift : 3x12 hr nights Start Date : 11 / 17 / 2025 Duration : 5 weeks Pay : $14...Show moreLast updated: 19 days ago