Delegation Specialist

BC Forward is looking for Delegation Specialist Remote (FL-based preferred)

Job Title: Delegation Specialist
Location: Remote (FL-based preferred)
Target Start Date: April 14, 2025
Pay Rate: $30.00/hour
Assignment Duration: 6 months (with potential to extend or convert to FTE)
Schedule: Monday - Friday, 8:00 AM - 4:30 PM (OT opportunities based on performance)

Position Purpose

As a Delegation Specialist, you will serve as the primary point of contact for assigned delegated entities, ensuring compliance with NCQA standards and Centene's delegation oversight policies. This role requires a strong mix of audit execution, provider data management, and communication across internal and external stakeholders.

Key Responsibilities

Conduct delegation audits for assigned functional areas. Communicate reporting requirements and expectations to delegated entities. Ensure compliance with NCQA standards and internal delegation oversight protocols. Maintain and manage delegation-related documentation, including rosters, ownership disclosures, W-9s, and agreements. Support Credentialing Committee activities. Compile and present audit findings and monitoring results to management. Maintain strong partnerships with internal stakeholders and delegated groups. Assemble pre-delegation packets and oversee the onboarding of new delegated entities. Participate in meetings, respond to shared mailbox requests, and complete special projects as needed. Track and meet the 45-day turnaround time for processing requests. Travel may be required based on health plan needs.

Required Qualifications

Education: Bachelor's degree in Business, Healthcare, or related field (or equivalent experience). Experience: Minimum 2 years in delegation, credentialing, or provider data management. Licensure: Valid driver's license and car insurance may be required (if travel is applicable).

Preferred Qualifications

NAMSS Credentialing Certification Working knowledge of NCQA delegation standards

Skills & Competencies

Top Must-Have Skills (in order of importance):

Excel & Reporting - Proficient with formulas and data management. Communication - Strong written and verbal skills to interact with internal and external partners. Time Management - Ability to prioritize tasks, meet strict deadlines, and pivot as needed.

Other Key Skills:

Organizational attention to detail Problem-solving and decision-making Ability to work independently and manage a high volume of submissions (target: 300/month)

Why This Role is Unique

Be part of a growing, high-impact team of 4 Delegation Specialists and 1 Sr. Delegation Specialist. Opportunity to directly impact provider satisfaction and regulatory compliance. Gain exposure to NCQA standards and high-level audit preparation in a fast-paced, metrics-driven environment. Flexible work hours with remote setup for Florida-based candidates.

Interested candidates please send resume in Word format Please reference job code 240664 when responding to this ad.

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