POSITION SUMMARY/ OBJECTIVE
The Director of Delegation responsible for the overall development, maintenance, and ongoing operations and oversight of the delegate and subcontractors, supporting Independent Living Systems plans and program. Director will oversee Delegation Oversight Manager in managing the various delegates and subcontractors. Director will staff ILS Delegation Oversight Committees. Director will ensure all delegates and subcontractors are meeting all regulatory and contractual requirements. Director will negotiate contracts, and act as point of contact for ongoing contractual and provider service issues.

REQUIREMENTS FOR ALL POSITIONS
All employees shall meet specified training programs including Compliance/Privacy Regulations and attend at a minimum one (1) hour of Compliance/Privacy educational training annually, as required by Florida Community Care (FCC).
All employees shall meet Risk Management Regulations, and attend at the minimum one (1) hour of Risk Management education and training within the first thirty (30) days of employment and as required by law or Florida Community Care; and, for that non-physician in clinical direct care delivery services, annually thereafter.
All employees if duly licensed in the State of employment, and said license is part of requirement of their position with Independent Living Systems, shall maintain in good standing and current state licensure.
All employees are required to maintain confidentiality, protect privacy, comply with PHI regulations, and report violations.

POSITION RESPONSIBILITIES AND ACCOUNTABILITY
Core duties and responsibilities include the following. Other duties may be assigned.

• Ability to negotiate AHCA and CMS compliant subcontractor and delegation contracts. Able to negotiate competitive reimbursement rates, and contract language changes as necessary.
• Maintain complete and updated knowledge of global managed care reimbursement methodologies, market competitive rates, and contractual structures.
• Manage Delegation Oversight Managers in overseeing the various subcontractors and delegates. Ensure proper oversight and engagement, including regularly scheduled (weekly, bi-weekly) meetings with key stakeholders with both ILS and subcontractors.
• Ensure preparation and loading of contracts into computer systems. Maintain and audit provider network file and directories.
• Conduct pre-delegation audits of all subcontractors and delegates. Prepare all necessary documentation for regulatory and accreditation requirements prior to subcontract implementation.
• Oversee compliance with the contract between various business units and the provider / subcontractor, to include the request, receipt and closure of corrective action plans, when necessary to address operational deficiencies.
• Ensure Delegation Oversight Managers review and receive timely. accurate and complete regulatory and contractual required reports
• Coordinate annual audits to measure the performance, including the request, receipt and closure of corrective action plans
• Identifies network needs in both new and existing service areas, investigate options, and initiate subcontractor negotiations in coordination with senior leadership.
• Renegotiate/renew existing contracts using analysis of cost and utilization data, gaps in service and quality reports to ensure network adequacy at efficient pricing
• Assist in preparation of updating Provider/Facility Manual
• Working with compliance to ensure subcontractors and delegates adhere to all regulatory, contact, and quality assurance requirements.
• Review, investigate and resolve delegate and provider service issues in conjunction with ILS internal departments. Analyze and research service care log data and claims data to develop proactive strategies to address delegate and provider issues and work with necessary departments to resolve.

POSITION QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to lead team(s), motivate others and engage others at all levels.
• Formal presentation skills required.
• Ability to analyze complete concepts including Provider Reimbursement methodologies, reports, etc. and provide resolution within required timeframes.
• Highly-organized and self-motivated.
• Capable of working independently.
• Ability to interact with people of all ages and cultural backgrounds.

KNOWLEDGE, SKILLS AND ABILITIES

• Verbal Communication: Excellent verbal communication skills with the ability to clearly present information orally and/or influence others through oral presentation
• Written Communication: Excellent written communication skills with the ability to effectively write and extract information from written material.
• Teamwork: Ability to work with People and effectively motivate others to achieve company goals and objectives.
• Organization and Planning: Ability to prioritize, organize tasks and develop the necessary action plan to accomplish specific goals, within required timeframes/deadlines.
• Decision Making & Problem Solving: Ability to identify a problem and implement interventions and solutions while exhibiting good sound judgement in the process; ability to take a systematic approach to decision making by identifying a problem or deficiency, examining the cause or barriers and implementing interventions and improvement strategies.

EDUCATION AND EXPERIENCE

• Bachelor's Degree and at least three (3) years of managed care contracting experience.
• Proficiency of Microsoft Office applications including Office, Excel, and Outlook.

PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands, reach with hands and arms; talk and hear. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
Must be able to work in a stressful environment.

WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.

DRUG FREE WORKPLACE
In compliance with the Drug-Free Workplace Act of 1988, Florida Community Care has a longstanding commitment to provide a safe, quality-oriented and productive work environment. Alcohol and drug abuse pose a threat to the health and safety of FCC employees and members and to the security of the company's equipment and facilities. For these reasons, FCC is committed to the elimination of drug and alcohol use and abuse in the workplace.
TRAVEL
This position requires up to 25% travel.

Job Type: Full-time

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Miami, FL 33166: Reliably commute or planning to relocate before starting work (Required)

Education:

• Bachelor's (Required)

Experience:

• Microsoft Excel, Microsoft Office: 1 year (Required)
• Managed care: 3 years (Required)
• negotiate AHCA, CMS compliance and delegation contracts: 1 year (Required)

Work Location: One location

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