Description
Reporting to the Associate Director of Delegation Oversight and Systems,
the Delegation Oversight Manager will lead the day-to-day management and
execution of our health plan's Delegation Oversight program. This critical role
ensures that delegated entities, including Independent Physician Associations
(IPAs), medical groups, and supplemental benefit vendors, comply with CMS,
DMHC, and NCQA regulations while meeting contractual, operational, and
performance standards.

Key Responsibilities:

+ Lead regulatory monitoring, audit readiness, and corrective action planning for delegated functions.
+ Manage the full oversight cycle, including performance monitoring, data submission compliance, Joint Operations Committee facilitation, remediation tracking, and risk escalation.
+ Collaborate with internal teams such as Data Integration & Reporting, Performance & Engagement, Compliance, Network Management, Supplemental Benefit Manag...