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UM, Delegation Specialist
4 months ago
Job Description
Job Description
Under the general direction of the UM Delegation Specialist, the UM Delegation Coordinator is responsible for preparing, coordinating, and collaborating with UM and MPM departmental teams to facilitate delegated activities i.e. audit documents, regulatory reporting, and regulatory committee meetings. The UM DO Coordinator must have the ability to deliver quality results with tight deadlines and maintain accurate records and documentation.
Duties and Responsibilities
Prepare and submit all standard and nonstandard compliance documents and research-related issues of a highly complex nature and recommend solutions
Requests, collects, and distributes a variety of documentation from departmental teams necessary to facilitate the auditing and monitoring functions
Ensures auditing and monitoring documentation is complete, and received promptly
Interacts with departmental and MPM stakeholders for deliverable reviews and approvals
Maintain MPM and Health Plan training materials
Attend scheduled UM Committee meetings and assist with developing meeting packets, minutes, and follow up on action items for all client groups
Assist with the development and reporting of quarterly & annual UM ICE Coalition reports
Assist with maintaining and updating PPG Policies and Procedures per health plan and regulatory requirements
Collaborate with UM delegation specialist and work closely with the VP of Medical Affairs and key contact for all UM compliance and non-compliance-related inquiries and issues
Assist with UM pre-delegation/Annual Audit UM Document submission
Assist with the development of NCQA/Audit Standards road mapping
Assist with guidance and support on complying with delegated plan functions
Perform any other job-related assignments, as needed
Minimum Job Requirements
Knowledge of and application of regulatory and quality standards and measures including but not limited to State Medicaid Programs, Medicare, and Quality Accreditation (e.g., State Medicaid regulations, CMS, NCQA, etc.)
2+ years of Managed Care experience required.
Knowledge of audit processes and applicable federal regulatory and accredited standards
Skill and Abilities
Effective verbal and written communication skills, a must
Exceptional attention to details
Excellent planning and organizational skills
Ability to prioritize and manage multiple tasks simultaneously
Strong interpersonal skills; ability to collaborate effectively with both internal and external contacts
Ability to work independently and take direction
MedPOINT, a large MSO in the San Fernando Valley, offers competitive salaries and benefits in a collaborative working environment. For immediate consideration of this position, please e-mail your resume and salary requirements to
personnel@medpointmanagement.com
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