Onsite Gainesville: Delegated Network Compliance Lead

UF Health; Gainesville (FL); On-site; USD 90,000 - 120,000; Full time

Job summary

UF Health in Gainesville, FL is seeking a Delegated Network Compliance & Audit Manager to coordinate audit readiness, compliance monitoring, and governance activities for the delegated network.

You will work with Managed Care, Medical Staff Services, Provider Enrollment, Revenue Cycle, Physician Services, and regional teams to prepare for payor reviews, track CAPs, and maintain documentation, while ensuring NCQA standards alignment and audit-ready processes.

Qualifications

• Bachelor's degree required in healthcare administration, business administration, public health, or related field.
• 3–5 years of experience in healthcare operations, managed care, provider enrollment, credentialing, compliance, audit, or related function.
• Experience supporting regulatory compliance, delegated network oversight, payor audits, or compliance monitoring.

Responsibilities

• Lead coordination of delegated network audit readiness, including documentation collection and validation for payor reviews, pre-delegation assessments, and compliance evaluations.
• Coordinate onsite and virtual audits while maintaining centralized documentation and supporting materials.
• Monitor delegated network compliance with NCQA standards, payor delegation requirements, regulatory expectations, internal policies, and SLAs.
• Identify compliance gaps, operational risks, and documentation deficiencies; track trends and escalate high-risk concerns.
• Partner with operational leaders to develop, monitor, and track corrective action plans (CAPs) and remediation activities.
• Support the UF Health Delegated Network Governance Committee by coordinating meetings, agendas, documentation, minutes, and action items.
• Prepare dashboards, compliance reports, leadership updates, and governance metrics for oversight.
• Assist with development and maintenance of delegated network policies, procedures, NCQA crosswalks, and audit readiness documentation.
• Collaborate with cross-functional teams to ensure ongoing audit-readiness and compliant delegated activities.
• Drive continuous process improvement across the delegated network.

Skills

Healthcare compliance

Delegated network ops

Regulatory interpretation

Project coordination

Time management

Communication

Attention to detail

Education

Bachelor's degree in Healthcare Administration or related field

Job description

UF Health in Gainesville, FL is seeking a Delegated Network Compliance & Audit Manager to coordinate audit readiness, compliance monitoring, and governance activities for the delegated network.

You will work with Managed Care, Medical Staff Services, Provider Enrollment, Revenue Cycle, Physician Services, and regional teams to prepare for payor reviews, track CAPs, and maintain documentation, while ensuring NCQA standards alignment and audit-ready processes.