Delegation Audit Specialist

Job Summary

A company is looking for a Delegation Audit Specialist to manage client-initiated audits and ensure compliance with regulatory obligations.

Key Responsibilities

• Coordinate and manage the full lifecycle of delegation audits from health plan clients
• Draft and coordinate comprehensive responses to audit requests, ensuring compliance with relevant standards
• Implement and maintain audit tracking systems and performance reports for compliance leadership

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business, Public Policy, or a related field
• Minimum of three years of experience in pharmacy benefit management, managed care, or health plan compliance
• At least two years of direct experience managing delegation audits or accreditation reviews
• Strong project management and organizational skills
• Working knowledge of regulatory and accreditation standards such as CMS, URAC, and NCQA