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Senior Auditor, Delegation Oversight (Remote)

April 30, 2026

JOB DESCRIPTION Job Summary Provides senior level audit support for delegation oversight activities. Responsible for ensuring delegates are complaint with the applicable state, federal, contractual requirements, National Committee for Quality Assurance (NCQA), and Molina requirements for the health plan(s) they support. Identifies risk and non-compliance, issues corrective action, and actively manages the corrective action process to completion reducing and managing Molina’s risk. Essential Job Duties • Leads and performs pre-delegation, annual audits, and ensures all components of audit activities comply with contractual, regulatory, and accreditation requirements. • Conducts detailed and focused audits on delegates’ policies, procedures, case files and evidence of ongoing monitoring to ensure quality and cost-effective provision of delegated services. • Engages delegate leadership to educate, collaborate, and/or remediate risks to Molina. • Leverages highly skilled analytical insights and experience to identify delegate systemic issues and risks that impact the business; collaborates with health plans and/or corporate departments and other business owners to actively address and mitigate risk to Molina. • Conducts analysis of audit issues to identify root-causes, develops and issues corrective action plans (CAPs), and documents follow-up to ensure successful remediation. • Prepares, tracks and provides audit finding reports in accordance with departmental requirements. • Prepares, submits and presents audit reports to delegation oversight committees. • Presents audit findings to delegates, and makes recommendations for improvements based on audit results. • Collaborates with delegation oversight leadership to develop and maintain assessment tools. • Makes independent decisions on complex issues and project components. • Serves as subject matter expert on policies, regulations, contractual requirements and delegate contracts for the relevant area. • Remains current on applicable regulatory, contractual and accreditation requirements and standards; interprets regulatory, contractual and accreditation changes and assesses their impact on the relevant area. • Conducts outreach to multiple department heads regarding key performance indicator (KPI) data analysis for quarterly meetings. • Provides training and support to new and existing delegation oversight team members. Required Qualifications • At least 3 years of managed care experience, including at least 2 years of delegation oversight auditing experience, or equivalent combination of relevant education and experience. experience. • Ability to work independently or in a team, support multiple projects at once, and perform other duties or special projects as required. • Ability to collaborate cross-functionally across a highly matrixed organization. • Strong attention to detail and organizational skills. • Strong critical-thinking, and problem-solving/analytical abilities. • Strong interpersonal and verbal/written communication skills. • Microsoft Office suite proficiency (including Excel), and ability to learn/navigate new software programs. Preferred Qualifications Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN), Certified Clinical Coder (CCD), Certified Medical Audit Specialists (CMAS), Certified Professional in Healthcare Management (CPHM) and/or other health care certification/licensure. If licensed, license must be active and unrestricted in state of practice. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

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When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

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Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

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Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

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Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

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Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

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This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...