Job Details

Manager Delegation Oversight Monitoring

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 138 hospital-based locations, in addition to its home-based services and virtual care offerings.

The posted compensation range of $45.26 - $67.32 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

The Manager, Delegation Oversight Monitoring (DOM) reports directly to the Director of Delegation Oversight Performance Monitoring (DOPM). This manager will partner with the director to establish a specifically designed delegation audit program that effectively prevents and/or detects violation of applicable laws, regulations, and contractual requirements, which will protect the organization from liability. This position will provide oversight of the team's leading health plan audits, core function of letter templates and denial letter responses, and essential reporting for the department. Educate and ensure assigned team members understand and comply with applicable laws, regulations, and contractual requirements.

The Manager, Delegation Oversight Monitoring is responsible for conducting routine internal audits, providing follow-up, and overseeing timely resolution of identified deficiencies. Specifically, this will include health audit planning, supervising the review of audit files during fieldwork, oversighting and making determination about compliance findings, essential reporting and oversight of letter template functions. This position will be responsible for providing leadership, guidance, and oversight to a small team when directions and expectations are unclear.

Additionally, in this role, you will serve as a super user for Policy Manager, the organization's internal P&P document depository. You will partner closely with the CommonSpirit (CSH) Compliance team on this function and oversight responsibilities. You will assist the CSH Compliance team and organization in meeting privacy expectations of the compliance program, including: controls, policies & procedures, communications, and training.

This position is remote, with a preference for California residents. PST business hours will be expected.

Minimum Qualifications:

• 5+ years of experience working in compliance, health plan oversight, auditing, and/or state agency, within the health care industry.
• 2 years minimum of supervisory, team lead or experience leading projects/training
• Bachelors degree or 5+ years equivalent experience will be considered

Preferred Qualifications:

• Direct experience in a California MSO environment to support delegation oversight services preferred

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time.

CommonSpirit Health is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law.