[Remote] Delegate Improvement Auditor / Analyst

Note: The job is a remote job and is open to candidates in USA. Medica is hiring a Delegate Improvement Analyst III to support oversight, performance improvement, and regulatory compliance across delegated entities and internal teams. The role develops metrics and analyses, conducts audits, supports DHS and CMS audit readiness, and collaborates across departments to improve reporting and delegate performance.

Responsibilities

• Performs other duties as assigned
• Design and maintain performance metrics that evaluate delegate outcomes and compliance
• Develop reports and analyses that translate complex data into actionable insights
• Identify trends, risks, and improvement opportunities across delegated programs
• Communicate findings clearly to support informed decision-making
• Complete comprehensive audits based on state and federal regulatory requirements
• Analyze delegate performance against contractual, regulatory, and quality standards
• Partner with internal teams to identify gaps and recommend improvement strategies
• Monitor progress of corrective actions and validate sustained improvement
• Document findings and outcomes to support consistent oversight
• Support preparation for DHS and CMS site audits through data validation and reporting
• Collaborate with delegates and internal stakeholders to gather required documentation
• Respond to audit requests with accurate, timely, and defensible information
• Track audit findings and support resolution and follow-up activities
• Partner with clinical, operational, compliance, and analytics teams to align information
• Ensure data consistency across reports, submissions, and oversight tools
• Address discrepancies through root-cause analysis and coordination
• Promote shared understanding of delegate performance across the organization
• Provide guidance to peers on metrics interpretation, reporting standards, and analysis methods
• Identify opportunities to improve analytical tools, workflows, or oversight processes
• Recommend enhancements that strengthen accuracy, efficiency, and usability
• Share best practices that advance delegate improvement and analytical maturity

Skills

• Bachelor's degree in Nursing, Social Work, Healthcare Administration or related degree and / or equivalent work experience in related field
• 5+ years of work experience beyond degree
• All candidates must be legally authorized to work in the United States at the time of application
• Experience with care coordination, care or case management, and working with government programs strongly preferred
• Audit experience
• Experience and knowledge of Medicaid and SNP products
• Project management or program management experience
• Microsoft Office proficiency, including Word, PowerPoint and Excel

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• PTO
• Holidays
• Paid volunteer time off
• 401K contributions
• Caregiver services
• Remote role

Company Overview