[Hiring] Delegate Improvement Auditor / Analyst @Medica

Role Description

The Delegate Improvement Analyst III leads complex analytical efforts that support oversight, performance improvement, and regulatory compliance across delegated entities and internal teams. This role designs and delivers metrics, reports, and analyses that inform business decisions and drive improvements in quality, operational performance, and regulatory adherence. It works closely with DHS and CMS during audits and collaborates with internal departments to ensure accurate, integrated reporting and response readiness. Operating 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. Performs other duties as assigned.

Key Accountabilities

• Lead Development of Metrics, Reporting, & Analytical Insight
  • 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.
  • Communicate findings clearly to support informed decision-making.
• Support Delegate Oversight & Improvement Initiative
  • 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 progress of corrective actions and validate sustained improvement.
  • Document findings and outcomes to support consistent oversight.
• Coordinate DHS & CMS Audit Support Activities
  • Support preparation for DHS and CMS site audits through data validation and reporting.
  • Collaborate with delegates and internal stakeholders to gather required documentation.
  • Respond to audit requests with accurate, timely, and defensible information.
  • Track audit findings and support resolution and follow-up activities.
• Drive Cross-Functional Data Integration & Collaboration
  • Partner with clinical, operational, compliance, and analytics teams to align information.
  • Ensure data consistency across reports, submissions, and oversight tools.
  • Address discrepancies through root-cause analysis and coordination.
  • Promote shared understanding of delegate performance across the organization.
• Serve as an Analytical Resource & Contribute to Process Improvement
  • Provide guidance to peers on metrics interpretation, reporting standards, and analysis methods.
  • Identify opportunities to improve analytical tools, workflows, or oversight processes.
  • Recommend enhancements that strengthen accuracy, efficiency, and usability.
  • Share best practices that advance delegate improvement and analytical maturity.

Qualifications

• Bachelor's degree in Nursing, Social Work, Healthcare Administration or related degree and/or equivalent work experience in related field.
• 5+ years of work experience beyond degree.

Requirements

• Experience with care coordination, care or case management, and working with government programs strongly preferred.
• Audit experience.
• Experience and knowledge of Medicaid and SNP products.
• Project management or program management experience.
• Microsoft Office proficiency, including Word, PowerPoint, and Excel.

Benefits

• Competitive medical, dental, vision.
• PTO and Holidays.
• Paid volunteer time off.
• 401K contributions.
• Caregiver services.
• Many other benefits to support our employees.

Eligibility to work in the US

Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.