Delegation Oversight: Clinical Audit Coordinator

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• Provides ongoing monitoring and education to Subcontractors staff related to Clinical and behavioral health requirements, performs Clinical and Mental Health onsite audits, including scheduling and educating the subcontractors on purpose and process of oversight, oversees clinical processes for participating and prospective subcontractors related to medical and behavioral health

• Participate in development, implementation and management of process and system to monitor and evaluate Enterprise delegated activities to subcontractors, Medical groups, IPAs and vendors for Commercial, Exchange, Medicare and Medicaid products.

• Provide input and perform maintenance of Enterprise pre-delegated and delegated oversight documentation (policies, procedures, audit tools, guidelines, reporting formats, communication materials and scheduling) consistent with the intent of regulatory/accreditation requirements for the enterprise.

• Schedule and perform timel...