The Associate Vice President, Delegation Oversight and Clinical Audits reports to the General Counsel and is responsible for managing external clinical audit functions including delegation oversight audits as well as regulatory audits. Responsibilities include audit coordination as well as documentation, management and oversight of corrective action plans. The position is also responsible for development and maintenance of clinical policy. This role will work closely with the Utilization Management (UM)and Care Management (CM) teams regarding auditing functions, clinical policy and corrective action plans.
This leader will monitor quality and performance metrics while also providing recommendations on operational design and efficiencies. The position will collaborate with other stakeholders and functional areas to ensure organizational alignment of clinical and operational goals.