Nurse Auditor, Delegation Oversight
Core
Performing delegation oversight auditing to ensure delegates comply with upstream health plan contractual requirements, NCQA, federal, and state regulations.
Role type
Nurse Auditor (Delegation Oversight)
Builds
Compliance reporting and coaching recommendations for AltaMed Health Network delegates and sub-delegates
Domain
Healthcare / Managed Care / Utilization Management
Deliverable
dashboards & analysis
Required skills
California LVN license, Managed care experience, Utilization Management experience, Delegation oversight audit experience, State and federal regulations knowledge, Medicare/Medicaid program knowledge, BLS certification
Preferred skills
Lead or supervisory role experience in UM
Technologies
None stated
Responsibilities
Perform delegation oversight auditing activities, Report to Medical Services Delegation Oversight leadership, Provide consultation/instructional/coaching recommendations to improve compliance
Seniority
Mid-level, hands-on IC