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Delegation Oversight Specialist

Clayton, Missouri Apply Now Job ID 1186352 Category Compliance Organization Centene Corporation Schedule Full-time

Position Purpose: Monitor and evaluate the performance of national delegated vendors according to CMS, and NCQA, Federal and State requirements.

  • Manage and monitor vendors against CMS, contractual, Federal, State, and NCQA requirements
  • Review delegate’s documented process against contractual, state, federal, and NCQA requirements.
  • Develop and manage quality improvement and corrective action plans based on audit findings and vendor performance and communicate results
  • Coordinate and perform on-going monitoring of vendor activities to ensure compliance and deficiencies are identified
  • Collaborate with the health plans to ensure optimal management of the vendors
  • Perform process reviews of vendor audits of each entity to monitor progress on performance improvements
  • Facilitate Joint Oversight Committee meetings with internal and external partners, document discussions and action items
  • 30% travel required

  • Qualifications:

    Education/Experience: Bachelor’s degree in related field or equivalent experience. 2+ years of quality management or vendor oversight experience.

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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