Delegation Oversight & Compliance Specialist

Ardent Health Job OverviewExecutes the operational work of delegation oversight – audit preparation and response, roster accuracy, oversight reporting, and monitoring compliance of credentialing operations against delegation requirements.ResponsibilitiesPrepares files, documentation, and evidence for payer pre-delegation and annual audits.Collaborates with Manager of Credentialing to conduct internal file audits against NCQA and payer-specific delegation requirements; document findings and track remediation.Builds, validates, and reconciles delegated rosters for audits prior to submission; investigate and resolve roster discrepancies.Compiles quarterly and semi-annual oversight reports required under delegation agreements.Monitors ongoing compliance of credentialing operations against delegation standards and escalates gaps.Maintains delegation program documentation, polices, agreement records, and audit history.Supports the Credentials Committee with reporting and materials as directed.Maintains historical knowledge of existing network delegation arrangements.QualificationsJob Requirements:4+ years of experience in credentialing, audit, or managed care complianceExperience with credentialing file audit against defined standardsStrong analytical and reconciliation skills, particularly with roster and provider dataPrecise documentation habits and comfort producing audit-ready evidencePreferred Job Requirements:CPCS certification, or eligibility with intent to certifyDirect experience supporting payer delegation auditsRoster build and submission experienceKnowledge of NCQA delegation standards