Delegate Improvement Auditor / Analyst
About The Position
The Delegate Improvement Analyst III leads complex analytical efforts that support oversight, performance improvement, and regulatory compliance across delegated entities and internal teams. The role designs and delivers metrics, reports, and analyses to inform business decisions and improve quality, operational performance, and regulatory adherence. It works with DHS and CMS during audits and collaborates with internal departments to support accurate, integrated reporting and audit response readiness. With minimal supervision, the Analyst III applies advanced analytical judgment, serves as a resource to others, and contributes strategically to delegate oversight and improvement initiatives. Other duties may be assigned. This is a remote position. Candidates must have a primary home address in a state where Medica is registered as an employer: AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, or WI. Medica does not offer work visa sponsorship; candidates must be legally authorized to work in the United States at the time of application.
Requirements
- Bachelor's degree in Nursing, Social Work, Healthcare Administration, or a related field, and/or equivalent work experience in a related field.
- At least 5 years of work experience beyond degree.
- Microsoft Office proficiency, including Word, PowerPoint, and Excel.
Nice To Haves
- Experience with care coordination, care or case management, and working with government programs.
- Audit experience.
- Experience and knowledge of Medicaid and SNP products.
- Project management or program management experience.
Responsibilities
- 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, and communicate findings to support informed decisions.
- 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 corrective actions and validate sustained improvement; document findings and outcomes to support consistent oversight.
- Support DHS and CMS site audit preparation through data validation and reporting.
- Collaborate with delegates and internal stakeholders to gather required documentation and respond to audit requests with accurate, timely, defensible information.
- Track audit findings and support resolution and follow-up activities.
- Partner with clinical, operational, compliance, and analytics teams to align information and ensure consistency across reports, submissions, and oversight tools.
- Address data discrepancies through root-cause analysis and coordination, promoting shared understanding of delegate performance.
- Guide peers on metrics interpretation, reporting standards, and analysis methods.
- Identify opportunities to improve analytical tools, workflows, and oversight processes; recommend enhancements that strengthen accuracy, efficiency, and usability.
- Share best practices that advance delegate improvement and analytical maturity.
- Perform other duties as assigned.
Benefits
- Competitive medical, dental, and vision benefits.
- PTO and holidays.
- Paid volunteer time off.
- 401K contributions.
- Caregiver services.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
