Delegation Oversight Coordinator

🕒 5 days ago

🌽 Illinois, Montana, +3 more states – Remote

🌽 Illinois – Remote 🦬 Montana – Remote 🌶️ New Mexico – Remote 🌪️ Oklahoma – Remote 🤠 Texas – Remote

💵 $55.9k - $123.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Responsible for creating, managing and reporting processes designed to monitor and evaluate activities and functions delegated to contracted, delegated entities and vendors for assigned products and business lines • Monitor timeliness of all claims, accuracy of payments and denial ratios • Conduct quarterly and annual financial accuracy audits

🎯 Requirements

• Bachelor's degree in Business or Medical OR 4 or more years' experience in a managed care environment • 4 years in a leadership role that includes direct accountability and responsibility and direction of staff • 4 years’ experience in directly performing delegated oversight activities • Project Management skills and experience • Knowledge of regulatory/accreditation requirements and standards (TDI, NCQA, URAC) • Verbal and written communication skills • Organizational skills and the ability to handle multiple priorities • PC proficiency to include Word, Excel, PowerPoint and Lotus Notes • Ability to travel

🏖️ Benefits

• Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement