Healthcare Delegation Project Manager

This role is fully remote. Applicants must reside in Oregon, Washington, Utah, Idaho, or North Dakota and will work PST hours., * Lead the integration and alignment of delegation programs across affiliated health plans, evaluating existing processes, policies, systems, and workflows to identify gaps and develop comprehensive transition strategies.

• Manage pre-delegation assessments, ongoing monitoring, and audits of delegated entities across multiple healthcare functions and product lines to ensure contractual, regulatory, and accreditation requirements are met.
• Develop and implement standardized delegation policies, procedures, audit tools, workflows, and oversight practices that support consistent operations across multiple entities.
• Create and manage detailed project plans, timelines, readiness metrics, gap analyses, implementation guides, status reports, and other documentation to track integration progress and outcomes.
• Partner with cross-functional stakeholders to facilitate planning sessions, resolve integration challenges, drive process improvements, and support organizational change associated with delegation program alignment.
• Monitor delegation activities for compliance with NCQA Health Plan Accreditation standards and applicable regulatory requirements, including requirements affecting Medicaid and other health plan products.
• Maintain and enhance delegation audit methodologies, monitoring mechanisms, and reporting tools to support effective ongoing oversight and continuous improvement.
• Provide clear written and verbal updates to program leadership regarding project status, risks, dependencies, milestones, and recommended solutions.
• Provide guidance, coaching, and subject matter expertise to junior team members and other stakeholders involved in delegation oversight activities.

Our client is seeking a Senior Healthcare Delegation Project Manager to lead complex initiatives focused on integrating and standardizing delegation oversight across multiple health plans, entities, and product lines. The ideal candidate brings deep healthcare delegation expertise, strong project leadership skills, and a thorough understanding of regulatory and accreditation requirements, with the ability to translate complex requirements into scalable processes and guide cross-functional teams through organizational change., * 6+ years of progressive experience in healthcare administration, project leadership, health plan operations, or a related field, including at least 5 years focused on healthcare delegation oversight and contracting.

• Strong knowledge of NCQA Health Plan Accreditation requirements and hands-on experience coordinating, assessing, auditing, or monitoring delegated healthcare functions.
• Comprehensive understanding of delegated functions such as credentialing, utilization management, case management, appeals, and network management.
• Demonstrated success managing complex delegation initiatives, preferably involving health plan integrations, mergers, affiliate alignment, or standardization across multiple entities.
• Experience leading organizational change, process harmonization, and implementation efforts involving multiple stakeholders, systems, and operational teams.
• Medicaid accreditation and delegation experience is strongly preferred.
• Bachelor’s degree in healthcare administration, business administration, or a related discipline, or an equivalent combination of education and relevant professional experience. A master’s degree is preferred.
• PMP, CPHQ, or similar relevant professional certification is a plus.
• Familiarity with AI-enabled tools and their application to professional productivity, analysis, or decision-making is highly desired.
• Strong communication, facilitation, problem-solving, and documentation skills, with the ability to work effectively across complex healthcare organizations.
• Ability to travel locally or out of state as business needs require.