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Delegation Oversight Auditor/Coordinator - Hybrid in Dallas, TX
Dallas, Texas Tenet Practice ResourcesWe are seeking a highly skilled Senior Coordinator, Delegation Oversight with deep knowledge of Payor Credentialing regulatory requirements, including NCQA, URAC, CMS, and state-specific standards. This role plays a critical part in supporting and maintaining delegated relationships with National, Regional, and Local Health Plans across multiple states.
The ideal candidate will lead audits, manage contract compliance, and ensure data integrity to support our Physician Manpower and managed care strategy and ensure continuous adherence to credentialing delegation standards.
Education:
- Bachelor’s Degree in Healthcare Administration, Business, or related field preferred. Equivalent experience may be considered.
Experience:
- Minimum 3–5 years of experience in Delegation Oversight, Credentialing, Managed Care, or Health Plan auditing.
- Strong understanding of credentialing standards from NCQA, URAC, CMS, and State regulations.
- Experience working with national and regional payors and understanding of managed care contracting structures.
Skills & Competencies:
- Excellent verbal and written communication skills.
- High attention to detail and organizational skills.
- Ability to manage multiple priorities in a fast-paced environment.
- Strong analytical and problem-solving skills, including root cause analysis.
- Proficiency in identifying and resolving claim and data load issues.
- Capable of obtaining and verifying authorizations and referrals when necessary.
- Adept at contract review and negotiation with an understanding of delegated credentialing frameworks.
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