Responsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA, CMS and State Medicaid requirements including delegation standards and requirements contained in the delegation agreement. The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM delegates are compliant with all applicable State, CMS, and NCQA requirements, as well as Molina Healthcare business needs. In addition, the Delegation Oversight Nurse will assist the Delegation Oversight Manager with additional duties of the team. We are looking for LVN's with at least 4 years of UM experience, NCQA accreditation and knowledge of InterQual / MCG guidelines. Excellent computer multi-tasking skills and analytical thought process is important to be successful in this role. Productivity is important with turnaround times. Experience with Appeals, Auditing, Prior Authorization, Compliance and Quality will be a good fit for this position. Further details to be discussed during our interview process. CA located - Remote position.