Delegation Oversight Reporting Analyst

JOB SUMMARY

The Delegation Oversight Reporting Analyst is responsible for supporting delegated oversight reporting, regulatory compliance, and data validation activities within the Managed Services Organization (MSO). This role ensures the accurate, timely, and compliant submission of regulatory, health plan, and internal reports related to Utilization Management (UM), Case Management (CM), Claims, and other delegated operational functions.

The Delegation Oversight Reporting Analyst maintains reporting templates, validates data submitted by delegated entities, supports audit readiness, and monitors reporting compliance to ensure adherence to federal and California regulatory   requirements, including Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), Centers for Medicare & Medicaid Services (CMS), and health plan contractual obligations.

This position collaborates with Medical Management, Compliance, Claims, Provider Relations, IT, and delegated entities to ensure reporting accuracy, operational transparency, and compliance with delegation agreements and regulatory standards.

MINIMUM & PREFERRED QUALIFICATIONS:

Education/Training

Minimum: Bachelor’s degree in Healthcare Administration, Business Administration, Public Health, Data Analytics, or related field, or equivalent work experience.

Preferred: Master’s degree in Healthcare Administration, Public Health, or related field..

Experience

Minimum: At least five years of experience in healthcare operations, managed care reporting, delegation oversight, medical management, utilization management, or related reporting functions. Experience with regulatory reporting, data validation, and reporting compliance.

Preferred: Experience supporting delegated managed care oversight and regulatory audits.

Experience working in MSO, IPA, or health plan environment. Experience with reporting tools, data analytics, and reporting   systems. Advanced Microsoft Excel. SQL, Smartsheet, or reporting tools, sFTP submission processes. Reporting dashboards and analytics tools

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

Skills, Knowledge & Abilities

· Knowledge of delegation oversight, regulatory reporting, and managed care compliance requirements.

· Knowledge of DMHC, CMS, DHCS, NCQA, and health plan regulatory standards.

· Strong analytical and data validation skills.

· Strong reporting, documentation, and organizational skills.

· Ability to interpret regulatory requirements and reporting standards.

· Strong written and verbal communication skills.

· Ability to analyze operational data and identify trends.

· Ability to maintain confidentiality and data integrity.

· Strong problem-solving and process improvement skills.

· Ability to collaborate effectively across departments and with external stakeholders.

· Ability to manage multiple priorities and meet deadlines.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS

The physical demands described here are represented of those that must be met by an employee to successfully perform the   essential functions of this job. Prolonged sitting and computer work. Frequent use of keyboard, mouse, and office equipment. Occasional standing, walking, bending, and lifting up to 25 pounds. The role requires sustained concentration, analytical thinking, and attention to detail to ensure reporting accuracy and compliance. This position requires the ability to work under deadlines, manage multiple tasks, and maintain confidentiality when handling sensitive data.