Compliance Specialist - Delegation Oversight
Location: Philadelphia, PA (must hold active, unrestricted PA RN license)
Type: Contract
Overview:
The Delegation Oversight Specialist – RN plays a key role in ensuring that all delegated activities by vendors—such as Utilization Management (UM), Case Management (CM), and Appeals—are performed in full compliance with regulatory, contractual, and accreditation standards. This position is responsible for conducting comprehensive assessments, audits, and ongoing monitoring to uphold the organization’s commitment to quality, compliance, and member safety.
Key Responsibilities:
Qualifications:
Skills & Competencies:
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