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8110 Gatehouse Road, Falls Church, VA 22042

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Delegation Coordinator-Managed Care

Cambridge Court 617769 Full Time 8110 Gatehouse Road, Falls Church, VA, 22042, US

Job Description

As a Delegation Coordinator, you will assist the Lead Auditor with quality checks of all credentialing/re-credentialing functions for all service lines to include, but not be limited to, individual practitioners, facilities and CVO clients. To help achieve our mission, you will be responsible for all delegation auditing functions as well as researching, investigating and resolving complex/critical provider credentialing to include annual audits and all related reporting. Your ability to assist with special projects within the department, as needed, is of vital importance.

Job Responsibilities
  • Alerts Credentialing staff of any credentialing errors and changes in credentialing policies to ensure files are compliant with all governing standards.
  • Conducts follow up and research regarding additional information required and documents appropriately.
  • Takes ownership of all high priority applications to expedite processing.
  • Ensures that delegated audits achieve a 95 –100 percent performance score on each audit and ensures that they are conducted according to the applicable contract terms and timeliness.
  • Process initial and re-credentialing applications as assigned by Lead Auditor in an efficient and timely manner.
  • Maintains re-credentialing functions to ensure Inova Health System is compliant and within all applicable timelines to maintain delegation agreements.
  • Communicates status of applications to practitioners and all interested parties on a regular basis.
  • Maintains current knowledge of and ensures compliance with regulatory requirements and accrediting body standards.

Additional Requirements


Associates degree OR HS Diploma/GED and 3 additional years of experience


3 years of auditing or quality analysis experience from a managed care credentialing perspective to include standard credentialing functions


Preferred Certification in national association Medical Staff Services (N/AMSS)


-Excellent communication skills; both oral and written

-Organizational skills

-Strong analytical skills

-Knowledge of managed care credentialing to include practitioner, facility and CVO services

-Knowledge of managed care contracting to facilitate contracted delegation responsibilities to include annual audits and intermittent reporting