Delegation Oversight Coordinator (Remote)

About the Role

At Health Care Service Corporation (HCSC), our workforce is vital to our success, and we are committed to supporting their professional growth through tailored development programs. We invite you to join an organization dedicated to meaningful work and career advancement.

The Delegation Oversight Coordinator will be responsible for designing, managing, and reporting on procedures that monitor delegated activities handled by contracted entities and vendors across assigned products and business lines. This oversight ensures adherence to corporate and regulatory standards. The role requires monitoring claim processing timelines, payment accuracy, denial rates, and leading quarterly and annual financial accuracy reviews. Occasional travel within the designated territory is expected, typically less than 10% of the time.

Key Responsibilities

• Create and administer processes aligned with monitoring delegated functions for compliance and performance.
• Evaluate timeliness of claim submissions, accuracy of payments, and analyze denial ratios.
• Conduct quarterly and annual audits on financial accuracy of delegated activities.
• Ensure delegated entities meet all regulatory and accreditation standards.

Required Qualifications

• Bachelor’s degree in Business or Medical fields, or at least four years’ experience in managed care.
• Minimum four years in leadership roles involving direct staff management and accountability.
• Experience of at least four years performing delegated oversight tasks.
• Proficiency in project management principles and tools.
• Familiarity with accreditation and regulatory standards such as TDI, NCQA, and URAC.
• Strong written and verbal communication capabilities.
• Excellent organizational skills with the ability to manage multiple priorities efficiently.
• Competency in Word, Excel, PowerPoint, and Lotus Notes.
• Willingness to travel as business needs dictate (less than 10%).

Preferred Qualifications

• Experience working with PowerPoint and Visio software.
• Background in customer service, including use of call scripts, managing call metrics, caller verification for PHI security, handling inquiries, and following protocol.
• Tele-sales experience compliant with State Department of Insurance regulations.
• Professional communication skills, including polished email and phone etiquette.
• Ability to work efficiently under strict regulations and deadlines.
• Capability to juggle multiple projects with diverse timelines.

Additional Information

Sponsorship is not available for this role. The position supports a telecommute, remote work setting.

Compensation Range: $55,900 to $123,500 annually, with exact pay contingent upon qualifications, experience, and location.

Employment Statement

We are an Equal Opportunity Employer committed to creating an inclusive workplace where the unique attributes of each employee are valued and respected. Employment considerations are made regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected factors.