- Molina Healthcare (Long Beach, CA)
- …state Medicaid UM auditing experience. + Three years' experience in delegation oversight process and working knowledge of state and federal regulations. ... **Job Summary** Responsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to...additional duties of the team. We are looking for LVN 's with at least 4 years of UM… more
- Molina Healthcare (Los Angeles, CA)
- **JOB DESCRIPTION** **Job Summary** The Manager, Delegation Oversight position is responsible for the management of staff and oversight of delegated ... We are looking for a candidate with a CA LVN , LPN or RN Nursing license, managed care Utilization...Medi-Cal knowledge, and Marketplace experience. This position will manage Delegation Oversight direct reports. Candidates with Medi-Cal… more
- Dignity Health (Bakersfield, CA)
- …**Minimum Qualifications:** - 3 years managed care experience - 1 year minimum of UM Delegation Oversight audit experience with Health Plan or large ... Nursing - Clear and current CA Licensed Vocational Nurse ( LVN ) - Knowledge in NCQA standards, DHCS, CMS, and...and DHMC regulatory requirements **Preferred Qualifications:** - 3-5 years UM /Case Management delegation oversight audit… more
- Molina Healthcare (UT)
- …financial, and quality of life outcomes. **Job Duties** + Responsible for oversight of clinical policy applicable to the Medicare population, ensuring compliance ... outcomes to ensure compliance. + Organizes and participates in Medicare UM Committee meetings, including preparing agendas and meeting minutes, facilitating related… more