Delegation Specialist - 210363

BC Forward is looking for Delegation Specialist Remote (FL-based preferred)

Job Title: Delegation Specialist
Location: Remote (FL-based preferred)
Target Start Date: April 14, 2025
Pay Rate: $30.00/hour
Assignment Duration: 6 months (with potential to extend or convert to FTE)
Schedule: Monday - Friday, 8:00 AM - 4:30 PM (OT opportunities based on performance)

Position Purpose

As a Delegation Specialist, you will serve as the primary point of contact for assigned delegated entities, ensuring compliance with NCQA standards and Centene's delegation oversight policies. This role requires a strong mix of audit execution, provider data management, and communication across internal and external stakeholders.

Key Responsibilities

• Conduct delegation audits for assigned functional areas.
• Communicate reporting requirements and expectations to delegated entities.
• Ensure compliance with NCQA standards and internal delegation oversight protocols.
• Maintain and manage delegation-related documentation, including rosters, ownership disclosures, W-9s, and agreements.
• Support Credentialing Committee activities.
• Compile and present audit findings and monitoring results to management.
• Maintain strong partnerships with internal stakeholders and delegated groups.
• Assemble pre-delegation packets and oversee the onboarding of new delegated entities.
• Participate in meetings, respond to shared mailbox requests, and complete special projects as needed.
• Track and meet the 45-day turnaround time for processing requests.
• Travel may be required based on health plan needs.

Required Qualifications

• Education: Bachelor's degree in Business, Healthcare, or related field (or equivalent experience).
• Experience: Minimum 2 years in delegation, credentialing, or provider data management.
• Licensure: Valid driver's license and car insurance may be required (if travel is applicable).

Preferred Qualifications

• NAMSS Credentialing Certification
• Working knowledge of NCQA delegation standards

Skills & Competencies

Top Must-Have Skills (in order of importance):

Other Key Skills:

• Organizational attention to detail
• Problem-solving and decision-making
• Ability to work independently and manage a high volume of submissions (target: 300/month)

Why This Role is Unique

• Be part of a growing, high-impact team of 4 Delegation Specialists and 1 Sr. Delegation Specialist.
• Opportunity to directly impact provider satisfaction and regulatory compliance.
• Gain exposure to NCQA standards and high-level audit preparation in a fast-paced, metrics-driven environment.
• Flexible work hours with remote setup for Florida-based candidates.

Interested candidates please send resume in Word format Please reference job code 240664 when responding to this ad.