SUPV - DELEGATION OVERSIGHT- Full Time

We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare.
Riverside Medical Clinic is the best place to work, practice medicine, and receive care.

SUMMARY: The Delegation Oversight (DO) Supervisor supervises day-to-day compliance with health plan delegation oversight requirements. The Supervisor reports to the Compliance Manager while supporting the Manager of Medical Management in the maintenance of utilization management (UM) operations and ensures routine reporting, ad hoc reporting, and leads annual DO audits. Develop strong and positive working relationships with health plan representatives and UM operational staff. The Supervisor is the technical expert for delegated health plan objectives and division of responsibility (DOR). The role will lead Riverside Medical Clinic (RMC) DO team to ensure compliance with Federal and State laws and regulations (Centers for Medicare and Medicaid Services, Department of Managed Health Care, Department of Health Care Services, CA Department of Insurance), contract provisions, and internal policies and procedures.

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The candidate must have strong attention to detail. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

HOURS: Monday- Friday 8:30AM- 5:30PM

EDUCATION and/or EXPERIENCE: High school diploma or GED required; undergraduate degree preferred. Minimum 2 years of experience in a health plan or healthcare auditing, compliance, or managed care operations. Familiarity with developing and implementing auditing and monitoring plans across systems and internal areas. Technical expert and comfortability navigating contracts, DORs, and division of financial responsibilities (DOFRs).

CERTIFICATES, LICENSES, AND REGISTRATIONS: None

Challenging and rewarding work environment
Growth and Development Opportunities within UHS and its Subsidiaries
Competitive Compensation

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.