OverviewThe purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.ResponsibilitiesThis position is remote, with the candidate residing within California, Arizona or Nevada .Position Summary:The Director of Delegation Oversight, Performance Monitoring is responsible for strategy, implementation, day to day operations, and supervising employees of the Delegation Oversight Monitoring team. The Director is responsible for maintaining a subject matter expertise of the operational, reporting, and accrediting requirements for all lines of business (Medicaid, Medicare, and Commercial) within the networks DHMSO provides services. The Director is the single point of contact for all performance monitoring issues related to delegates, and is responsible for maintaining strong lines of the communication with the leads for delegation oversight in the Compliance and Health Services Delivery (Case Management, Utilization Management, and Claims Operations) organizations, and is responsible for all necessary agency reporting.The Director is required to use strong organizational and communication skills to build and foster effective relationships, and to use critical thinking and problem solving skills to help ensure successful delegation partnerships and department quality. The core functional areas of oversight include: health plan audits, health plan communication, essential reporting, appeals/grievances and credentialing.QualificationsMinimum Qualifications:
At least 5 years of experience in contract and/or regulatory and/or accreditation requirements analysis in managed care or other related health care industries. At least 5-7 years shall include supervisory/management experience.
Bachelor's Degree. In lieu of degree, equivalent education and/or experience may be considered.
Preferred Qualifications:
Master's Degree preferred.
Preferred Certified HealthCare Compliance (CHC)
Certified in Healthcare Compliance Fellow (CHC-F) Certified preferred.
Compliance & Ethics Professional (CCEP) preferred.
Current California Registered Nurse (RN) license preferred.
Pay Range$51.66 - $74.91 /hourWe are an equal opportunity/affirmative action employer.