Senior Auditor for Delegation Oversight

Job Summary Join our team as a Senior Auditor focused on delegation oversight activities, where you will play a crucial role in ensuring compliance with various regulatory and contractual requirements for our health plans. Your efforts will directly help identify risks and manage compliance, thereby reducing and managing potential risks for Molina. Essential Job Duties Lead and conduct pre-delegation and annual audits to ensure adherence to all regulatory and accreditation standards. Perform detailed audits of delegate policies, procedures, and case files to ensure quality service delivery. Engage actively with delegate leadership to communicate risks and collaborate on solutions. Utilize your analytical skills to identify systematic issues and work with other departments to address and mitigate risks. Analyze audit findings to determine root causes and develop corrective action plans (CAPs). Prepare and track audit findings, ensuring accurate reporting in alignment with departmental standards. Present audit reports and findings to relevant committees and delegate leadership, offering improvement recommendations based on your assessments. Collaborate with oversight leadership to create and refine assessment tools. Make independent decisions regarding complex issues and project components. Act as a subject matter expert on related policies, regulations, and contracts. Stay updated on all regulatory and accreditation standards, interpreting changes and their implications. Participate in outreach efforts to discuss key performance indicators (KPIs) with department leadership. Provide training and support for both new and current team members in delegation oversight. Required Qualifications A minimum of 3 years in managed care, including at least 2 years focused on delegation oversight auditing, or an equivalent combination of education and experience. Able to work independently and within a team, handling multiple projects concurrently. Strong collaboration skills to work across a highly matrixed organization. Detail-oriented with exceptional organizational abilities. Strong critical-thinking and problem-solving skills. Excellent interpersonal and communication skills, both written and verbal. Proficient in Microsoft Office Suite, particularly Excel, with the ability to quickly learn new software. Preferred Qualifications Certifications such as Certified Credentialing Specialist (CCS), Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN), Certified Clinical Coder (CCD), Certified Medical Audit Specialists (CMAS), and Certified Professional in Healthcare Management (CPHM), or other relevant health care certifications. All licenses must be active and unrestricted in the respective practice state. Molina Healthcare is proud to be an Equal Opportunity Employer (EOE) M/F/D/V. We offer a competitive benefits and compensation package.Pay Range:$80,168 - $128,519 annually (actual compensation may vary based on geographic location, work experience, education, and skill level).

Created: 2026-03-06