Remote Claims Delegations Oversight Analyst

MedPOINT Management; Los Angeles (CA); Remote; USD 75,000 - 110,000; Full time

Benefits offered by this job

401(k)

401(k) matching

Bonus based on performance

Company parties

Dental insurance

Employee discounts

Health insurance

Opportunity for advancement

Paid time off

Parental leave

Savings bank

Training & development

Vision insurance

Wellness resources

Job summary

MedPOINT Management seeks a detail-driven Claims Delegations Oversight Specialist to join our team in Sherman Oaks, CA. This compliance-focused role ensures delegated claims operations meet regulatory and contractual standards, supporting our managed care network.

You will monitor, audit, and analyze claims data, collaborating with delegate organizations to develop corrective action plans and maintain thorough documentation for health plan partners and regulators.

Qualifications

• 2+ years in claims processing, managed care, or healthcare compliance.
• Knowledge of NCQA/DMHC standards and delegation oversight.
• Experience developing CAPs.
• Strong data interpretation and reporting skills.

Responsibilities

• Monitor and audit delegated claims entities for compliance.
• Conduct routine oversight reviews and site audits.
• Analyze claims data to identify trends and risk.
• Collaborate with delegate organizations on CAPs.
• Maintain documentation of oversight activities and findings.
• Coordinate with compliance, legal, and provider relations.
• Support preparation of reports for health plan partners and regulators.

Skills

Healthcare compliance

Analytical skills

Documentation

Cross-functional collaboration

Organizational skills

Tools

Excel

Claims management systems

Job description

MedPOINT Management seeks a detail-driven Claims Delegations Oversight Specialist to join our team in Sherman Oaks, CA. This compliance-focused role ensures delegated claims operations meet regulatory and contractual standards, supporting our managed care network.

You will monitor, audit, and analyze claims data, collaborating with delegate organizations to develop corrective action plans and maintain thorough documentation for health plan partners and regulators.