Delegation Specialist

Delegation Specialist

BC Forward is looking for Delegation Specialist (REMOTE) - in Florida

Position Title: Delegation Specialist (REMOTE)

Locations: Remote - FL
Anticipated Start Date: 04/01
Expected Duration: 6 Months
Job Type: Contract with possible extension
Shift: 8:00am - 4:30 pm
Pay Rate $30.00/hr. on W2
Need: Minimum of 5 years of experience in a corporate or professional setting. Proficiency in Excel (including data analysis and reporting).



Job Description:
Position Purpose:
Serve as the primary liaison with delegated entities, ensuring compliance with delegation oversight requirements. Conduct audits, manage reporting activities, and maintain adherence to NCQA standards within the assigned function.
Delegation Team Specialist
The Delegation Team processes requests from our Delegated Entities, managing a portfolio of 39 delegated groups with 13 additional entities in the process of becoming delegated. Requests are received via email through a shared mailbox.
The Delegation Team Specialist will be responsible for the following:

• Serve as the primary point of contact for delegated entities on delegation-related matters.
  
• Manage monthly delegated rosters and perform reconciliation.
  
• Maintain accurate and up-to-date provider information in relevant databases.
  
• Provide confirmation to delegated entities regarding their practitioners and facilities.
  
• Collect and verify annual required documents, including Disclosure of Ownership forms and W-9s.
  
• Oversee the repapering process for all delegated entities with the updated Delegated Contract Agreement.
  
• Compile and assemble pre-delegation packets for prospective delegated entities, ensuring compliance with delegation requirements.
  
• Conduct background screenings as needed.
  
• Prepare and submit the Quarterly Administrative Subcontractors and Affiliates Report.
  
• Communicate effectively with delegated entities to address inquiries and resolve issues.
  
• Attend and actively participate in meetings as required.
  
• Collaborate with internal stakeholders to support delegation processes and requirements.
  
• Assist with special projects as needed.
  

During the training and learning process, overtime (OT) will not be available. Once an employee consistently meets the required metrics of completing 300 monthly submissions within their 8-hour shift and can work independently, the opportunity for OT will be extended.
The standard work schedule is 8:00 AM - 4:30 PM, with some flexibility during the day. Employees are assigned specific groups for which they will be responsible, handling requests and serving as the primary point of contact for delegated matters.

Requests are received through a shared delegation mailbox, making time management crucial. Success in this role requires practical judgment, attention to detail, organizational skills, the ability to prioritize and pivot, strong written and verbal communication skills, problem-solving abilities, and the capacity to work effectively under pressure.
Education/Certification Required: High School diploma, Bachelor's degree
Must-Haves:

• Proficiency in Excel (including data analysis and reporting).
  
• Strong reporting knowledge and experience in generating insights.
  
• Minimum of 5 years of experience in a corporate or professional setting.
  

Nice-to-Haves:

• NAMSS Credentialing Certification.
  
• Familiarity with NCQA Standards.
  

Key Skills & Requirements

Excel Proficiency - Strong knowledge of Excel formulas and reporting capabilities.

Communication Skills - Effective written and verbal communication.

Time Management - Ability to prioritize tasks, manage deadlines, and work efficiently.

Key Responsibilities:

• Perform delegation audits to assess compliance with regulatory and contractual requirements.
  
• Communicate reporting expectations and oversee related activities for delegated entities.
  
• Ensure adherence to delegation monitoring and oversight requirements.
  
• Support the development and management of policies and procedures related to delegation maintenance.
  
• Assist with Credentialing Committee activities and related documentation.
  
• Report audit findings and delegation monitoring results to management.
  
• Foster strong relationships with delegated partners to ensure successful collaborations and quality outcomes.
  
• Provide support for additional department activities as needed.
  
• Depending on the assigned health plan, travel may be required.
  

Qualifications:

• Education & Experience: Bachelor's degree in Business, Healthcare, or a related field, or equivalent experience. Minimum of 2 years of experience in delegation oversight, provider data management, or a related area.
  
• Licenses & Certifications: A valid driver's license and car insurance may be required based on job responsibilities.
  

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.

Interested candidates please send resume in Word format Please reference job code 236880 when responding to this ad.

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