Nurse Auditor: Delegation Compliance & Oversight
AltaMed
Don’t send a generic resume — generate a resume and cover letter tailored to this exact role.
Benefits offered by this job
Job summary
AltaMed is seeking a Delegation Oversight Nurse Auditor in California to perform oversight audits ensuring delegates meet upstream health plan requirements and NCQA, federal, and state standards. The role includes reporting to AHN leadership and providing coaching to improve overall compliance for delegates and sub-delegates.
Requirements include an active California nurse license (LVN), 3+ years in managed care, 2+ years UM experience, and 1 year in delegation oversight or equivalent leadership
Qualifications
- Unrestricted California nurse license (LVN) and active certification.
- Minimum 3 years managed care experience.
- Minimum 2 years Utilization Management (UM) experience.
- 1 year of delegation oversight or 2+ years UM in lead/supervisory role.
- Working knowledge of federal/state regulations and Medicare/Medicaid programs.
Responsibilities
- Perform delegation oversight auditing to ensure compliance with health plan requirements.
- Provide guidance to improve compliance of delegates and sub-delegates.
- Report findings to AHN Medical Services Delegation Oversight leadership.
- Offer instructional coaching to enhance regulatory adherence.
Skills
Education
Job description
AltaMed is seeking a Delegation Oversight Nurse Auditor in California to perform oversight audits ensuring delegates meet upstream health plan requirements and NCQA, federal, and state standards. The role includes reporting to AHN leadership and providing coaching to improve overall compliance for delegates and sub-delegates.
Requirements include an active California nurse license (LVN), 3+ years in managed care, 2+ years UM experience, and 1 year in delegation oversight or equivalent leadership
'/%3e%3cpath%20d='M101.744%2012.4726L102.894%2016.1947L99.0021%2013.2201L101.744%2012.4726ZM105.3%208.40937H100.488L99.0026%203.59473L97.5116%208.41047L92.7%208.40385L96.5965%2011.3834L95.1055%2016.1942L99.0021%2013.2196L101.408%2011.3834L105.3%208.40992V8.40937Z'%20fill='white'/%3e%3cdefs%3e%3clinearGradient%20id='paint0_linear_5593_1381'%20x1='90'%20y1='9.44471'%20x2='99'%20y2='9.44471'%20gradientUnits='userSpaceOnUse'%3e%3cstop%20stop-color='%2300AD70'/%3e%3cstop%20offset='0.998594'%20stop-color='%2300B67A'/%3e%3cstop%20offset='1'%20stop-color='%23DCDCE6'/%3e%3c/linearGradient%3e%3c/defs%3e%3c/svg%3e){kind=small}
