Delegation Oversight Specialist - Hybrid (PA/NJ/DE)
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The Delegation Oversight Specialist is an excellent communicator (written and verbal) who is detail oriented, organized, able to read and interpret regulations and able to meet tight deadlines while handling multiple audits. This position will be involved with ensuring Independence compliance with NCQA accreditation standards, regulatory requirements. Candidate will be able to work independently and with a team, demonstrate self-motivation and enthusiasm. Responsibilities include:
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Qualifications:
- Bachelor's Degree in business or a healthcare related field or equivalent work experience.
- Experience with data analytics or auditing strongly desired.
- Experience in auditing regulatory requirements is desired.
- Credentialing and recredentialing experience preferred
- Knowledge of Medicare Advan
- 6 years in a managed care or insurance industry with previous M
- tage and Medicare Prescription Drug Programs operations and regulations is preferred.edicare Advantage or Part D experience preferred.
- Intermediate proficiency in the use of Office365 (e.g. Microsoft Word, Excel) required.
Hybrid
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.
At Independence Blue Cross, all qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Inclusion and Belonging
At AmeriHealth Administrators, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
AmeriHealth Administrators is one of the largest national third-party administrators providing innovative, value-based health benefits programs and outsourcing services for self-funded health plans and other organizations.
The company also provides customized outsourcing services for TPAs and other payers, student health plans, and fully insured products.
AmeriHealth Administrators serves 1 million plan members in all 50 states and processes over 6 million claims annually.
Equal Employment Opportunity
AmeriHealth Administrators is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth Administrators employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth Administrators and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth Administrators or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.