Curana Health is a provider of value-based primary care services for the senior living industry, including skilled nursing facilities, assisted & independent living communities, Memory Care units, and affordable senior housing sites. Our 1,000+ clinicians serve more than 1,500 senior living community partners across 34 states, and Curana participates in various innovative CMS programs (including owned-and-operated Accountable Care Organizations and Medicare Advantage plans). With rapid year-over-year growth since our founding in 2021, Curana is setting a new standard in innovative care delivery for seniors with high-risk, complex clinical needs, many of whom have been historically underserved by the healthcare system. Our mission: To radically improve the health, happiness and dignity of senior living residents.

Job Summary:

The Credentialing Delegation Oversight Senior Specialist is responsible for monitoring and ensuring the compliance and quality of delegated credentialing functions within the health plan. This role focuses on ongoing compliance with state and federal regulations, including Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), and National Committee for Quality Assurance (NCQA) standards. The ideal candidate will have direct experience with delegated credentialing and bring strong analytical, auditing, and process improvement skills to support the organization.

Responsibilities:

• Conduct, coordinate, and document credentialing delegation assessments to ensure compliance with state, federal, NCQA, and internal requirements.
• Evaluate performance of delegated entities and review submitted reports for completeness, accuracy, and timeliness.
• Identify deficiencies or non-compliance in delegated activities and develop appropriate corrective action plans; track follow-up through resolution.
• Collaborate with internal teams and delegated entities to ensure consistent adherence to credentialing delegation standards and contractual obligations.
• Assist in the planning and facilitation of Delegation Oversight Committee meetings, including preparation of agendas, presentation materials, and follow-up documentation.
• Partner with the Network Management team to develop, review, and update delegation agreements and assessment tools.
• Maintain audit documentation and prepare evidence for external regulatory audits, including state oversight visits and NCQA accreditation surveys.
• Monitor reporting requirements and maintain tracking systems to ensure timely and complete receipt of required documentation from delegated entities.
• Participate in continuous quality improvement initiatives within the Delegation Oversight Department.

Knowledge & Skills Required:

• Bachelor’s Degree in Healthcare Administration, Business, or a related field; or an equivalent combination of education and relevant experience.
• Minimum 3 years of experience in a managed care or health plan environment.
• At least 1 year of direct experience conducting delegation oversight assessments or audits, with emphasis on credentialing.
• Experience with compliance monitoring, audit processes, or provider performance evaluations.
• Data analysis and reporting experience required.

Curana Health is dedicated to the principles of Equal Employment Opportunity. We affirm, in policy and practice, our commitment to diversity. We do not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable or state law, genetic information, or any other characteristic protected by applicable federal, state and local laws and ordinances.

The EEO policy applies to all personnel matters as outlined in our company policy including recruitment, hiring, transfers, and general treatment during employment.

*The company is unable to provide sponsorship for a visa at this time (H1B or otherwise).