Delegation Oversight

Healthcare Support Staffing; Long Beach (CA); On-site; USD 41,000 - 51,000; Full time

Job summary

HealthCare Support Staffing, Inc. (HSS) is a leading healthcare recruiting and staffing firm placing professionals with major healthcare facilities across the United States.

We are seeking an RN or LVN with strong NCQA/HEDIS knowledge and extensive managed care experience to coordinate delegation assessments and ensure compliance. You will develop reports, action plans, and follow-up to address deficiencies, ensuring timely submission of required documents and reports.

Qualifications

• Must be RN or LVN.
• Bachelor’s degree in related field or equivalent experience.
• Familiarity with physician referrals, medical decision-making, working in a clinical environment, compliance practices.
• 1+ years clinical experience as RN
• 8-10 years managed care experience
• Extensive knowledge of MS Word/Excel/Access
• Knowledge of NCQA and HEDIS standards and applicable state and federal laws

Responsibilities

• Coordinates, conducts, and documents delegation assessments as necessary to comply with state, federal, NCQA, and any other applicable requirements.
• Develops format and documents periodic status reports from Delegated Entities.
• Develops corrective action plans when deficiencies are identified, and documents follow-up to completion.
• Ensures delegated entity’s compliance with reporting requirements by tracking the receipt and completeness of reports.
• Develops corrective action plans when compliance issues are identified, and document follow-up to completion

Skills

Clinical experience

Compliance knowledge

NCQA/HEDIS knowledge

Physician referrals familiarity

Medical decision-making

Education

Bachelor’s degree in related field or equivalent experience

Tools

MS Word

MS Excel

MS Access

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

• Coordinates, conducts, and documents delegation assessments as necessary to comply with state, federal, NCQA, and any other applicable requirements.
• Develops format and documents periodic status reports from Delegated Entities.
• Develops corrective action plans when deficiencies are identified, and documents follow-up to completion.
• Ensures delegated entity’s compliance with reporting requirements by tracking the receipt and completeness of reports.
• Develops corrective action plans when compliance issues are identified, and document follow-up to completion

Qualifications

• Must be RN or LVN
• Bachelor’s degree in related field or equivalent experience
• Familiarity with physician referrals, medical decision-making, working in a clinical environment, compliance practices
• 1+ years clinical experience as RN
• 8-10 years managed care experience
• Extensive knowledge of MS Word/Excel/Access
• Knowledge of NCQA and HEDIS standards and applicable state and federal laws

Additional Information

Hours: Monday-Friday 8:00am to 5:00pm, no OT, nights, no weekend or travel

Pay rate: $30-$37/hr