Nurse Auditor, Delegation Oversight

AltaMed Health Services Corporation; Montebello, Northern (CA, KY); Hybrid; USD 69,000 - 82,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

403(b) retirement plan

Flexible Spending Accounts

Commuter benefits

Career Advancement & Development

Paid Time Off & Holidays

Paid CME Days

Malpractice tail coverage

Tuition Reimbursement

Corporate Employee Discounts

Employee Referral Bonus

Pet Care Insurance

Job summary

AltaMed Health Services Corp. in Montebello, CA is seeking a Nurse Auditor for Delegation Oversight to perform audits ensuring delegates meet health plan requirements and NCQA, federal, and state standards.

The role involves advising on corrective actions and guiding delegates to compliant practices. The ideal candidate holds an active CA nursing license (RN or LVN), with 3+ years in managed care, 2+ years in utilization management, and BLS certification.

Qualifications

• Current and active, unrestricted California Nurse license (RN or LVN).
• Minimum of 3 years of experience in managed care.

Responsibilities

• Perform delegation oversight auditing to ensure compliance with upstream health plan requirements.
• Provide consultation and coaching to improve delegation and sub-delegation adherence to regulations.
• Report findings and collaborate with AHN Medical Services Delegation Oversight leadership.

Skills

Nursing license

Managed care

Utilization management

Delegation oversight

BLS certification

Job description

## Nurse Auditor, Delegation OversightApply: In Person: Montebello, CA 90640: Full time: Posted Yesterday: JR10812**Grow Healthy**If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.**Job Overview**The Delegation Oversight Nurse Auditor is responsible for performing delegation oversight auditing activities to ensure delegates comply with upstream health plan contractual requirements. This also includes NCQA, federal, and state regulations and standards. This position utilizes a rapid team approach for needed improvements identified through audits and monitoring activities. The oversight responsibility of this position includes reporting to AltaMed Health Network (AHN) Medical Services Delegation Oversight leadership and providing consultation/instructional/coaching recommendations to improve overall compliance of delegates and sub-delegates with regulatory entities and standards.**Minimum Requirements*** Current and active, unrestricted California Nurse license, LVN.* A minimum of 3 years of experience in managed care is required.* Minimum of 2 years Utilization Management experience required.* Minimum of 1 year of delegation oversight (D) audit experience required. Instead of delegation oversight experience, we will consider candidates with 2+ years of UM experience, preferably in a lead and/or supervisory role.* Working knowledge of state and federal regulations.* Knowledge and experience with Medicare/Medicaid programs.* A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines.**Compensation**$68,640.00 - $82,368.00 annually**Compensation Disclaimer**Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.**Benefits & Career Development*** Medical, Dental and Vision insurance* 403(b) Retirement savings plans with employer matching contributions* Flexible Spending Accounts* Commuter Flexible Spending* Career Advancement & Development opportunities* Paid Time Off & Holidays* Paid CME Days* Malpractice insurance and tail coverage* Tuition Reimbursement Program* Corporate Employee Discounts* Employee Referral Bonus Program* Pet Care Insurance**Job Advertisement & Application Compliance Statement**AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.