Delegation Specialist

BC Forward is Looking for Delegation Specialist Remote FL

Job Title: Delegation Specialist
Location: Remote, FL
Work Schedule: Monday-Friday, 8:00 AM - 4:30 PM (no OT during training; flexible hours post-training)
Pay Rate: $30.00/hour
Assignment Duration: 6 months (possibility to extend or convert)
Target Start Date: April 14, 2025

Position Purpose:

Serve as the primary liaison to delegated provider groups, performing delegation audits, tracking reporting deliverables, maintaining compliance with NCQA standards, and ensuring successful delegation oversight. This role requires exceptional organizational and communication skills to manage provider data and relationships efficiently and compliantly.

Key Responsibilities:

• Conduct delegation audits for assigned functions ensuring adherence to NCQA and internal standards.
• Communicate reporting requirements to delegated entities and monitor submission compliance.
• Oversee monthly delegated rosters and ensure timely reconciliation.
• Maintain current and accurate provider information in applicable systems.
• Collect required documentation (e.g., W-9, Disclosure of Ownership forms).
• Manage administrative delegation duties including credentialing support and contract repapering.
• Assemble and manage pre-delegation audit packets.
• Coordinate quarterly subcontractor and affiliate reporting.
• Report audit findings and monitoring outcomes to leadership.
• Attend internal and external meetings as a representative of the Delegation team.
• Collaborate with internal departments and complete special projects as assigned.
• Travel may be required depending on the assigned health plan.

Education/Experience:

• Required:
• Bachelor's degree in Business, Healthcare, or related field (or equivalent experience)
• 2+ years of experience in delegation oversight or provider data management
• 5+ years in a corporate or professional environment
• Preferred:
• NAMSS Credentialing Certification
• Familiarity with NCQA standards

Skills and Competencies:

Top 3 Must-Have Skills (in order of priority):

Additional Skills:

• Problem-solving and decision-making under pressure
• High attention to detail
• Strong organizational skills
• Ability to prioritize, pivot, and meet performance metrics (300 monthly submissions; 45-day TAT)
• Experience in credentialing processes a plus

Team & Culture:

You'll join a close-knit team of 4 Delegation Specialists and 1 Senior Specialist. The team works collaboratively, with shared responsibilities managed via a group mailbox. Training is thorough, and performance is closely monitored to ensure compliance and high-quality outcomes. Team success is measured by audit scores (targeting 95%+), timely request processing, and maintaining compliance to avoid member/provider impact.

Interview Process:

• 1 virtual interview (via Microsoft Teams)

Benefits:

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 238383 when responding to this ad.