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Manager Delegation Oversight information

What is a manager delegation oversight?

A Manager Delegation Oversight is a professional responsible for monitoring and managing the performance and compliance of delegated entities, such as vendors or subcontractors, on behalf of an organization. Their role involves ensuring that these third parties adhere to contractual, regulatory, and company standards. They often review reports, conduct audits, and coordinate corrective actions if issues are identified. This position is especially common in industries like healthcare, insurance, and finance, where regulatory compliance is critical. The goal is to mitigate risk and ensure quality through effective oversight of delegated functions.

What are the key skills and qualifications needed to thrive as a manager delegation oversight?

To thrive as a Manager Delegation Oversight, you need expertise in healthcare compliance, delegated entity management, and risk assessment, often supported by a bachelor's degree in healthcare administration or a related field. Familiarity with regulatory frameworks (such as NCQA, CMS, or URAC), audit management tools, and reporting systems is essential. Strong organizational, analytical, and interpersonal communication skills help in building relationships and resolving compliance issues with delegated entities. These abilities ensure effective oversight, regulatory compliance, and high-quality performance from contracted partners, which are critical for organizational success.

What are some common challenges faced by a manager delegation oversight, and how can they be effectively addressed?

Managers in Delegation Oversight often face challenges such as ensuring compliance with regulatory requirements, maintaining clear communication with delegated entities, and monitoring performance across multiple partners. To address these challenges, it's important to establish robust monitoring systems, conduct regular audits, and foster strong relationships with both internal teams and external vendors. Staying updated on regulatory changes and proactively identifying areas for process improvement can also help ensure effective oversight and minimize risks.

What cities are hiring for Manager Delegation Oversight jobs?

Cities with the most Manager Delegation Oversight job openings:

What are the most commonly searched types of Delegation Oversight jobs?

The most popular types of Delegation Oversight jobs are:

What states have the most Manager Delegation Oversight jobs?

States with the most job openings for Manager Delegation Oversight jobs include:

Manager Delegation Oversight jobs near you
Infographic showing various Manager Delegation Oversight job openings in the United States as of July 2026, with employment types broken down into 2% As Needed, 85% Full Time, 12% Part Time, and 1% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution.

Sr. Manager - Claims Delegation Audit

Astrana Health

Monterey Park, CA • On-site, Remote

$125K - $140K/yr

Full-time

Re-posted 2 days ago

Job description

The Senior Claims Manager, Claims Delegation Oversight, is responsible for the management and oversight of all Claims Delegation Audits, including health plan and governing agencies audits, i.e., DMHC, CMS, and DHCS. This role will be responsible for the development and execution of department strategies, overall Audit program, Audit process optimization, and management, identifying and leveraging technology and data to improve the quality and minimizing process cost of Claims. The position alongside the leadership team will contribute to driving strategic planning, operational excellence, and accuracy of the claims process and ensure compliance with regulations and contract requirements for Medicare, Commercial Exchange, and Medicaid service lines. 
Our Values: 
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team
External Audit planning, execution & support 
  • Own the endtoend strategy and execution of all external audits (e.g., CMS, DMHC, health plan audits), ensuring readiness, successful delivery, and continuous score improvement
  • Lead audit planning, preaudit readiness reviews, execution, issue tracking, and final reporting
  • Establish and monitor audit metrics, scorecards, and dashboards; ensure timely, accurate communication of results
  • Oversee corrective action plan (CAP) management, including root cause analysis, remediation, and prevention strategies
  • Partner with Claims Operations to ensure audit findings are remediated promptly and sustainably
Documentation, Compliance & Training
  • Review and approve auditrelated policies, procedures, workflows, job aids, and SOPs for accuracy and regulatory compliance
  • Ensure adherence to all legislative, regulatory, and contractual requirements
  • Identify training gaps, oversee training strategy and delivery, and measure training effectiveness
CrossFunctional Collaboration & Process Improvement
  • Collaborate closely with internal partners (Claims, UM, CM, Pharmacy, Compliance, IT, Finance, Configuration, Network, and others) to resolve issues and drive operational excellence
  • Partner with IT and Data Analytics to develop and maintain audit tools, reports, dashboards, and scorecards
  • Recommend and support system, rules, and workflow improvements impacting claims adjudication and audit outcomes
  • Lead or support special projects, including new business implementations, business analyses, and strategic initiatives
People Leadership
  • Set team goals, define success metrics, and drive accountability
  • Recruit, develop, coach, and motivate a highperforming team
  • Track performance and guide the team to achieve audit and operational objectives
Other duties as assigned
  • Bachelor's degree (BA/BS) or equivalent combination of education and experience
  • Have at least 3 years of claims administration experience within a Health Plan, IPA, or MSO environment
  • Have at least 3 years of experience supporting or overseeing health plan and delegation audits
  • Have at least 3 years of people leadership experience, including coaching and performance management
  • Handson claims auditing experience, including root cause analysis and corrective action management
  • Have advanced knowledge of CMS, DHCS, DMHC, Medicare, MediCal, and Medicaid regulations impacting claims adjudication
  • Strong understanding of claims payment methodologies (e.g., RBRVS, DRG/APDRG, APC, Medicare/MediCal fee schedules)
  • Proficiency in Excel, including creating and maintaining reports and data summaries
  • Highly organized, adaptable, and able to prioritize in a fastpaced environment with minimal supervision
  • Proven ability to lead, coach, and motivate teams toward defined performance goals
  • Strong analytical, problemsolving, and decisionmaking skills
You're great for the role if
  • Master's Degree
  • Have experience with claims systems and tools (e.g., EzCap, IDX, Cotiviti, Burgess)
  • Familiarity with clearinghouses (e.g., Office Ally), core system implementation, and configuration
  • This position is remotely based in the U.S. The home office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754.
  • The national target pay range for this role is $125,000 - $140,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action Employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change. 

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