Tenet Healthcare
Delegation Oversight Auditor/Coordinator - Hybrid in Dallas, TX
Tenet Healthcare, Dallas, Texas, United States, 75215
Overview
Delegation Oversight Auditor/Coordinator
- Hybrid in Dallas, TX. This role supports and maintains delegated relationships with National, Regional, and Local Health Plans across multiple states. The position requires deep knowledge of Payor Credentialing regulatory requirements, including NCQA, URAC, CMS, and State-specific standards, and plays a critical part in audits, contract compliance, and data integrity to support the Physician Manpower and managed care strategy. Responsibilities
Lead audits and manage contract compliance to ensure adherence to credentialing delegation standards. Maintain data integrity and timely reporting to payors, including rosters, performance metrics, and audit responses. Coordinate provider data loading, resolve data discrepancies, and support timely claims processing in partnership with internal teams and health plan contacts. Review, redline, and negotiate delegation agreements and contracts to align with internal strategy and regulatory obligations. Ensure clear definitions of roles, responsibilities, reporting metrics, and performance expectations across internal teams. Support onboarding and maintenance of provider portfolios to ensure adherence to credentialing and contracting standards. Investigate root causes of compliance or operational issues and drive corrective actions to improve delegation performance and reduce delays. Act as liaison between internal departments and external health plan partners and maintain positive relationships with stakeholders at all levels, including executive leadership. Maintain documentation to support audits, internal reviews, and health plan submissions. Ensure accurate and timely loading of provider data to avoid claims delays or denials. Qualifications
Bachelor’s Degree in Healthcare Administration, Business, or related field preferred. Equivalent experience may be considered. 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. Excellent verbal and written communication skills; high attention to detail and strong organizational abilities. Ability to manage multiple priorities in a fast-paced environment; strong analytical and problem-solving skills, including root cause analysis. Compensation
$60,528 - $78,624 - $96,720 Education & Certifications
Education Bachelor’s Degree in Healthcare Administration, Business, or related field preferred. Equivalent experience may be considered. Work Arrangement
Hybrid in Dallas, TX Equal Opportunity
Employment practices will not be influenced by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
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Delegation Oversight Auditor/Coordinator
- Hybrid in Dallas, TX. This role supports and maintains delegated relationships with National, Regional, and Local Health Plans across multiple states. The position requires deep knowledge of Payor Credentialing regulatory requirements, including NCQA, URAC, CMS, and State-specific standards, and plays a critical part in audits, contract compliance, and data integrity to support the Physician Manpower and managed care strategy. Responsibilities
Lead audits and manage contract compliance to ensure adherence to credentialing delegation standards. Maintain data integrity and timely reporting to payors, including rosters, performance metrics, and audit responses. Coordinate provider data loading, resolve data discrepancies, and support timely claims processing in partnership with internal teams and health plan contacts. Review, redline, and negotiate delegation agreements and contracts to align with internal strategy and regulatory obligations. Ensure clear definitions of roles, responsibilities, reporting metrics, and performance expectations across internal teams. Support onboarding and maintenance of provider portfolios to ensure adherence to credentialing and contracting standards. Investigate root causes of compliance or operational issues and drive corrective actions to improve delegation performance and reduce delays. Act as liaison between internal departments and external health plan partners and maintain positive relationships with stakeholders at all levels, including executive leadership. Maintain documentation to support audits, internal reviews, and health plan submissions. Ensure accurate and timely loading of provider data to avoid claims delays or denials. Qualifications
Bachelor’s Degree in Healthcare Administration, Business, or related field preferred. Equivalent experience may be considered. 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. Excellent verbal and written communication skills; high attention to detail and strong organizational abilities. Ability to manage multiple priorities in a fast-paced environment; strong analytical and problem-solving skills, including root cause analysis. Compensation
$60,528 - $78,624 - $96,720 Education & Certifications
Education Bachelor’s Degree in Healthcare Administration, Business, or related field preferred. Equivalent experience may be considered. Work Arrangement
Hybrid in Dallas, TX Equal Opportunity
Employment practices will not be influenced by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
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