Talent.com
LVN Delegation Oversight Nurse Remote
LVN Delegation Oversight Nurse RemoteMolina Healthcare Careers • Post Falls, ID, US
serp_jobs.error_messages.no_longer_accepting
LVN Delegation Oversight Nurse Remote

LVN Delegation Oversight Nurse Remote

Molina Healthcare Careers • Post Falls, ID, US
job_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.filters.remote
job_description.job_card.job_description

JOB DESCRIPTION

Job Summary

The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for overseeing delegated activities to ensure compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and requirements pertaining to delegation agreements. Contributes to overarching strategy to provide quality and cost-effective member care.

This position will support our Corporate Compliance business. The candidate must have an unrestricted LVN licensure. Candidates must be technologically proficient, self-directed, autonomous and experience working from home. Care Management & Waiver Service Auditing experience is highly preferred.

Work hours : Monday - Friday 8 : 00am – 4 : 00pm

Remote position

Essential Job Duties

  • Coordinates, conducts and documents pre-delegation and annual assessments as necessary to comply with state, federal and National Committee for Quality Assurance (NCQA) guidelines, and other applicable requirements.
  • Distributes audit results letters, follow-up letters, audit tools and annual reporting requirement as needed.
  • Works with delegation oversight analytics representatives on monitoring performance reports from delegated entities.
  • Develops corrective action plans (CAPs) when deficiencies are identified, and documents follow-up to completion.

Assists with delegation oversight committee meetings.

  • Works with delegation oversight leadership to develop and maintain delegation assessment tools, policies and reporting templates.
  • Assists with preparation of delegation summary reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and / or utilization management committees.
  • Participates as needed in joint operation committees (JOCs) for delegated groups.
  • Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid, National Committee for Quality Assurance (NCQA) and / or other regulatory audits as needed.
  • Required Qualifications

  • At least 3 years' experience in health care, including 2 years' experience in a managed care environment facilitating utilization reviews, or equivalent combination of relevant education and experience.
  • Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). The license must be active and unrestricted in state of practice.
  • Knowledge of audit processes and applicable state and federal regulations.
  • Ability to work effectively in a fast-paced, high-volume environment, maintain accuracy and meet established deadlines.
  • Ability to collaborate effectively with team members and internal departments.
  • Strong attention to detail with a focus on maintaining quality in all tasks.
  • Strong verbal and written communication skills.
  • Microsoft Office suite / applicable software program(s) proficiency.
  • Preferred Qualifications

  • Registered Nurse (RN). The license must be active and unrestricted in state of practice.
  • Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified Professional in Healthcare Quality (CPHQ).
  • To all current Molina employees : If you are interested in applying for this position, please apply through the Internal Job Board.

    Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V

    Pay Range : $77,969 - $128,519 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • serp_jobs.job_alerts.create_a_job

    Lvn Nurse • Post Falls, ID, US

    Job_description.internal_linking.related_jobs
    Travel Neuro Stepdown Telemetry RN

    Travel Neuro Stepdown Telemetry RN

    Anders Group • Spokane, WA, US
    serp_jobs.job_card.full_time
    Anders Group is seeking a travel nurse RN Med Surg for a travel nursing job in Spokane, Washington.Job Description & Requirements. Pay package is based on 12 hour shifts and 36 hours per week (s...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Med Surg

    Travel Nurse RN - Med Surg

    Nightingale Nurses • Coeur d'Alene, ID, US
    serp_jobs.job_card.full_time
    Nightingale Nurses is seeking a travel nurse RN Med Surg for a travel nursing job in Coeur d Alene, Idaho.Job Description & Requirements. You may not realize it, but as an RN with real world hos...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Med Surg / Telemetry

    Travel Nurse RN - Med Surg / Telemetry

    Stability Healthcare • Coeur d'Alene, ID, US
    serp_jobs.job_card.full_time
    Stability Healthcare is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Coeur d'Alene, Idaho.Job Description & Requirements. Stability Healthcare is looking for a ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Med Surg

    Travel Nurse RN - Med Surg

    Nurse First • Coeur d'Alene, ID, US
    serp_jobs.job_card.full_time
    Nurse First is seeking a travel nurse RN Med Surg for a travel nursing job in Coeur d'Alene, Idaho.Job Description & Requirements. Pay package is based on 12 hour shifts and 36 hours per wee...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Med Surg

    Travel Nurse RN - Med Surg

    Magnet Medical • Coeur d'Alene, ID, US
    serp_jobs.job_card.full_time
    Magnet Medical is seeking a travel nurse RN Med Surg for a travel nursing job in Coeur D Alene, Idaho.Job Description & Requirements. Magnet Medical Job ID #34563799.Pay package is based on 12 h...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Outpatient Registered Nurse - RN

    Outpatient Registered Nurse - RN

    Fresenius Medical Care • Deer Park, Washington, US
    serp_jobs.job_card.full_time
    The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and co...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    RN - Oncology

    RN - Oncology

    Providence Health and Services • Post Falls, ID, US
    serp_jobs.job_card.part_time
    Sign-On Bonus for eligible positions and eligible rehires that meet required qualifications and conditions for payment.Providence nurses are not simply valued – they’re invaluable.You w...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Med-Surg Telemetry Registered Nurse

    Travel Med-Surg Telemetry Registered Nurse

    AHS Staffing • Coeur d'Alene, ID, US
    serp_jobs.job_card.full_time
    AHS Staffing is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Coeur d'Alene, Idaho.Job Description & Requirements. AHS Staffing is looking for a Med - Surg / Tele ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Hospice

    Travel Nurse RN - Hospice

    Skyline Med Staff Home Health • Coeur d'Alene, ID, US
    serp_jobs.job_card.full_time
    Skyline Med Staff Home Health is seeking a travel nurse RN Hospice for a travel nursing job in Coeur d`Alene, Idaho.Job Description & Requirements. Weekly amount stated in the job postings is es...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    MDS Coordinator (Registered Nurse / RN)

    MDS Coordinator (Registered Nurse / RN)

    Life Care Center of Post Falls • Post Falls, ID, US
    serp_jobs.job_card.full_time
    Life Care Center of Post Falls is situated in a growing\ncommunity in Idaho's panhandle, offering residents a blend of small-town charm\nand access to larger city amenities in nearby Coeur d&rs...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Hospice

    Travel Nurse RN - Hospice

    Connected Health Care • Coeur d'Alene, ID, US
    serp_jobs.job_card.permanent +1
    Connected Health Care is seeking a travel nurse RN Hospice for a travel nursing job in Coeur d'Alene, Idaho.Job Description & Requirements. Connected Health Care is a nationally recognized h...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    REGISTERED NURSE (RN) - OPERATING ROOM

    REGISTERED NURSE (RN) - OPERATING ROOM

    Northwest Specialty Hospital • Post Falls, ID, US
    serp_jobs.job_card.full_time
    Northwest Specialty Hospital is seeking a passionate Circulating RN to join our OR Team!.This position is eligible for a $1,000 sign-on bonus! • •. Our surgery center has 12 operating rooms, 3 procedu...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Nurse Practitioner

    Nurse Practitioner

    DOCS Health • Post Falls, ID, US
    serp_jobs.job_card.full_time
    Attention all Nurse Practitioners, we are calling you to partner with us as independent contractors providing services to our Military Service members. We primarily work weekends, with some occasion...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    RN Resident - Medical Oncology

    RN Resident - Medical Oncology

    Providence Health and Services • Liberty Lake, WA, US
    serp_jobs.job_card.full_time
    RN Resident - Medical Oncology, Providence Holy Family Hospital, Spokane, WA.Providence is offering up to $15,000 Hiring Bonus for eligible external candidates who meet all conditions for payment -...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    Travel Nurse RN - Med Surg

    Travel Nurse RN - Med Surg

    CrossMed • Coeur d'Alene, ID, US
    serp_jobs.job_card.full_time
    CrossMed is seeking a travel nurse RN Med Surg for a travel nursing job in Coeur d'Alene, Idaho.Job Description & Requirements. At CrossMed Healthcare Staffing, we aim to create lasting impr...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Neurosurgery Operating Room Registered Nurse

    Travel Neurosurgery Operating Room Registered Nurse

    Bestica • Spokane, WA, US
    serp_jobs.job_card.full_time
    Bestica is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Spokane, Washington.Job Description & Requirements. Is on-call required : Yes 1x / wk, 1 wk / 6 wk sched.Are weeke...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    MDS Coordinator (Registered Nurse / RN)

    MDS Coordinator (Registered Nurse / RN)

    Life Care Center of Coeur d'Alene • Coeur d'Alene, ID, US
    serp_jobs.job_card.full_time
    Life Care Center of Coeur d’Alene is located in a city\nrenowned for its pristine lake and outdoor recreational activities. Residents\nenjoy boating, hiking, and skiing, as well as a charming ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Cardiology

    Travel Nurse RN - Cardiology

    Wellspring Nurse Source • Coeur d'Alene, ID, US
    serp_jobs.job_card.full_time
    Wellspring Nurse Source is seeking a travel nurse RN Cardiology for a travel nursing job in Coeur D Alene, Idaho.Job Description & Requirements. Wellspring Nurse Source Job ID #34562949.Pay pack...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Neuro Stepdown Telemetry RN

    Travel Neuro Stepdown Telemetry RN

    American Traveler • Spokane, WA, US
    serp_jobs.job_card.full_time
    American Traveler is seeking a travel nurse RN Med Surg for a travel nursing job in Spokane, Washington.Job Description & Requirements. American Traveler is seeking an experienced RN for a Neuro...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    RN - CVOR

    RN - CVOR

    Providence Health and Services • Post Falls, ID, US
    serp_jobs.job_card.full_time
    Up to $20,000 hiring bonus for eligible external hires that meet required qualifications and conditions for payment!.Registered Nurse (RN) - CVOR at Providence Sacred Heart Medical Center, Spokane,...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted