Insight Global is looking for a Delegation Oversight Nurse for one of their largest healthcare clients located in southern California. This position is 100% remote but they must sit 50 miles from Irvine to pick up equipment.
Primary Responsibilities:
* In collaboration with the Manager of Delegation Compliance Clinical Services, manages delegation oversight and regulatory audits.
* Leverages knowledge of clinical services regulatory and delegation requirements to represent Optum Clinical Services appropriately while managing delegation oversight audits
* Serves as a liaison between Health Plan delegated entities and Clinical Services Operational teams (Utilization Management and Case Management)
* Serves as a liaison between Delegation Compliance and cross-functional areas/departments across the organization
* Uses, protects, and discloses Optum patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
They must sit 50 miles from Irvine: 8am-5:00pm PST.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to
HR@insightglobal.com.
To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy:
https://insightglobal.com/workforce-privacy-policy/ .
* Graduation from an accredited Licensed Vocational/Practical Nurse program
* Current LVN/LPN license in State of Residence
* 2+ years of care management, utilization review (prior authorization) or discharge planning experience
* Experience in an HMO or experience in a Managed Care setting
* A base knowledge of requirements for Medicare, Medi-Cal and Commercial lines of business
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.