Manager, Regional Delegation Oversight

Posted 3 Days Ago
Be an Early Applicant
Hiring Remotely in United States
Remote
Senior level
Insurance
The Role
Manages regional delegation oversight across multiple states, ensuring delegated entities comply with state, federal, NCQA, and organizational requirements. Oversees audits, corrective action plans, risk monitoring, regulatory documentation, committee meetings, performance reporting, and entity onboarding or offboarding. Leads a delegation oversight team by hiring, training, mentoring, and managing performance while collaborating with internal stakeholders and senior leadership.
Summary Generated by Built In

***Remote and must live in the United States***

JOB DESCRIPTION 

Job Summary

Leads and manages a regional team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements.  Collaborates closely with internal business owners to manage and administer the relationships and performance of delegated entities including health plan onboarding and offboarding activities, management of oversight activities, audits and corrective action plans, issuance and service issue escalations, and ongoing risk monitoring.


Essential Job Duties

• Oversees and manages the day-to-day operations of the delegation oversight program for assigned states and respective state delegates within a designated region.
• Chairs monthly meetings of region and/or state (where contractually required with the state regulator) delegation oversight committee, including review of agendas and meeting minutes, and documents for committee oversight of delegated functions.
• Coordinates, evaluates, and reviews delegation audit assessment tools as necessary to comply with state, federal, National Committee for Quality Assurance (NCQA), and any other applicable requirements.
• Manages department processes, monitors performance of delegated entities on regulars intervals, and assigns corrective action plans (CAPs) when deficiencies are identified.
• Prepares delegation oversight document evidence for state regulatory audits.
• Collaborates with national delegation oversight senior leadership in the development of new and updates to existing delegation audit tools and policies/procedures.
• Prepares delegation oversight performance reports for presentation to health plans and senior leadership.
• Hires, trains, mentors, develops, and manages delegation oversight team, and demonstrates accountability for team performance.
 

Required Qualifications

• At least 7 years of related auditing/vendor/data management experience, preferably in delegation oversight, or equivalent combination of relevant education and experience.
• At least 1 year management/leadership experience.
• Ability to build relationships and manage a team.  
• Strong critical-thinking and problem-solving/analytical abilities.
• Strong time-management, organizational, detail orientation and prioritization skills.
• Strong project management skills and knowledge of project management tools/processes.
• Strong data processing/analysis experience.
• Ability to interpret error reports and identify remediation steps.
• Ability to collaborate cross-functionally across a highly matrixed organization.
• Strong interpersonal and verbal/written communication skills.  
• Microsoft Office suite proficiency (including Excel), and ability to learn/navigate new software programs.
 

Preferred Qualifications

• Delegation oversight experience.
 

#PJHPO

#LI-AC1


To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Skills Required

  • At least 7 years of related auditing, vendor management, or data management experience, preferably in delegation oversight, or an equivalent combination of education and experience.
  • At least 1 year of management or leadership experience.
  • Ability to build relationships and manage a team.
  • Strong critical-thinking, problem-solving, and analytical abilities.
  • Strong time-management, organizational, detail-orientation, and prioritization skills.
  • Strong project management skills and knowledge of project management tools and processes.
  • Strong data processing and analysis experience.
  • Ability to interpret error reports and identify remediation steps.
  • Ability to collaborate cross-functionally across a highly matrixed organization.
  • Strong interpersonal and verbal and written communication skills.
  • Proficiency with Microsoft Office, including Excel, and ability to learn and navigate new software programs.
  • Delegation oversight experience.

Molina Healthcare Inc. Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Molina Healthcare Inc. and has not been reviewed or approved by Molina Healthcare Inc..

  • Healthcare Strength — Health coverage is described as solid, including medical, dental, and vision insurance alongside options like HSA/FSA and disability coverage. Benefits are often seen as a meaningful part of the overall package.
  • Retirement Support — A 401(k) with employer matching and an ESPP are offered, and the retirement plan is commonly regarded as a plus. These features help round out compensation even when base pay is seen as only acceptable.
  • Leave & Time Off Breadth — PTO, paid holidays, and paid parental leave are part of the offering, with time‑off benefits generally viewed favorably. Backup family care and an employee assistance program add practical support.

Molina Healthcare Inc. Insights

Am I A Good Fit?
beta
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company

What We Do

Molina Healthcare Inc. is dedicated to delivering effective, reliable, and affordable health care to those who need it most. The company focuses on improving the health and well-being of its members and positively impacting the communities it serves. Recognized as a leader in the health insurance category, it provides essential healthcare services to ensure accessible and quality care for its members.

Similar Jobs

Capital One Logo Capital One

Artificial Intelligence Engineer

Fintech • Machine Learning • Payments • Software • Financial Services
Remote or Hybrid
5 Locations
55000 Employees
286K-392K Annually

Optum Logo Optum

Director, Executive and Enterprise Storytelling - Remote

Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
In-Office or Remote
Eden Prairie, MN, USA
160000 Employees
135K-231K Annually

Optum Logo Optum

LVN or LPN, Case Manager - Remote

Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
In-Office or Remote
Cypress, CA, USA
160000 Employees
20-36 Hourly

Optum Logo Optum

Account Manager

Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Remote
Pennsylvania, USA
160000 Employees
20-36 Hourly

Similar Companies Hiring

MassMutual India Thumbnail
Big Data • Fintech • Information Technology • Insurance • Financial Services
Hyderabad, Telangana
Granted Thumbnail
Artificial Intelligence • Healthtech • Insurance • Mobile • Financial Services
New York, New York
23 Employees
Vega Thumbnail
Artificial Intelligence • Automotive • Insurance • Transportation
US
43 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account