MSLA is a Medical Corporation that provides comprehensive independent medical evaluations (IME) and other IME related services to the government and private industry. Our business philosophy incorporates both exceptional customer service and quality evaluations, both of which are the primary factors for our rapid growth since our inception in 1998. No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm) Primary Responsibilities:Coordinates the delegation annual auditing procedures including scheduling, creating audit tools and documentsCoordinates, conducts, and documents delegation assessments as necessary to comply with state, federal, NCQA, and any other applicable requirementsDevelops audit reports and corrective action plans when deficiencies are identified, and documents follow-up to completionEnsures delegated entity's compliance with reporting requirements by tracking the receipt and completeness of reportsAnalyzes and reviews delegated reporting from delegated entities and create performance dashboardsPrepare documents for Credentialing Committee oversight of delegated functionsWorks with internal departments to develop and maintain delegation agreements and assessment toolsDevelops and implements or assists with program to build/improve positive relationship with delegatesCoordinates internally with appropriate departments with regards to delegation communication, meetings, annual oversight audits, and delegation reportingUnderstand Medicaid, Medicare and other publicly funded programs
Required Qualifications:2+ years or more strong abilities to analyze and interpret legislative, statutory, regulatory, and legal language. (as an Auditor or Delegation Specialist)2+ years' experience in health care auditing, compliance, regulatory, investigation, and/or insurance/managed care experience required. (as an Auditor or Delegation Specialist)1+ year or more Developing audit reports and corrective action plans when deficiencies are identified, and documents follow-up to completionNAMSS Certification as a Certified Professional Services Manager (CPMSM) or Certified Provider Credentials Specialized (CPCS)Travel for physical audits as needed around 25% in the U.S. within Eastern StatesFamiliarity with Medicaid, Medicare and other publicly funded programsStrong project management experiencePreferred Qualifications:Bachelors of Arts or Bachelors of ScienceKnowledge of working with VA/GovernmentExemplary interpersonal skills, including ability to work effectively as part of a team across organizational structureAbility to meet deadlines and adjust to changes in policies, procedures, and priorities.Effective verbal and written communications skillsWillingness to take initiative to address problems and make continuous process improvementsStrong analytical problem solving skills with initiativeAbility to work independently is criticalStrong organizational/documentation skills Careers with MSLA. Our focus is simple. We're innovators at providing technology - driven, comprehensive, independent medical evaluations to government and private entities. In addition to our core clinics located throughout California, Nevada and Hawaii, we manage an extensive nationwide network of fully credentialed physicians in all major specialties. We've joined Optum, part of the UnitedHealth Group family of businesses. And when you join our team, you'll impact the lives of others by verifying the validity of claims, providing quality examinations and meeting the timelines that make a difference for our customers. Here, you'll join a team that makes you want to do better every day, resulting in your life's best work.(sm) https://www.mslaca.com/Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: MSLA, delegation specialist, Tampa, FL, Florida
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.