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CVS Health
Work at Home, Illinois, United States
(on-site)
Posted
1 day ago
CVS Health
Work at Home, Illinois, United States
(on-site)
Job Type
Full-Time
Industry
Other
Job Function
Other
Supervisor, Delegation Compliance
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Supervisor, Delegation Compliance
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Description
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.Company: Oak Street Health
Title: Supervisor, Delegation Compliance
Location: Remote
Role Description:
The Supervisor, Delegation Compliance leads a team of Delegation Compliance Associates to ensure Oak Street Health's delegated utilization management (UM) and care management (CM) programs meet all CMS, NCQA, contractual, and state/federal regulatory requirements. This role drives day‑to‑day audit execution, reporting, corrective action planning, survey readiness, and continuous quality improvement-coordinating closely with UM/CM operations, Quality, Business Intelligence, and Health Plan partners.
Operating as a non‑clinical compliance leader, the Supervisor provides hands‑on oversight of program auditing and monitoring, owns team performance against key metrics (on‑time reporting, audit pass rates, closure of CAPs/PIPs), and serves as a subject‑matter resource for delegation and accreditation standards. The Supervisor translates regulatory and contract requirements into practical workflows, tools, and training to safeguard compliance and support an exceptional patient and provider experience.
Core Responsibilities:
- Lead, coach, and develop Delegation Compliance Associates; manage workload, quality checks, performance feedback, and training needs.
- Ensure delegated UM/CM programs meet CMS, NCQA, contractual, and state/federal requirements; communicate regulatory updates and operational impacts.
- Serve as the internal subject‑matter resource for delegation compliance and partner with cross‑functional leaders to ensure operational alignment.
- Build, maintain, and execute audit protocols and tools; oversee chart/file audits, analyze trends, and identify root causes.
- Develop and monitor CAPs and PIPs; verify adequacy, progress, and long‑term sustainment of corrective actions.
- Recommend and implement process improvements to strengthen internal controls, efficiency, and outcomes.
- Review and update policies, procedures, program descriptions, and evaluations; develop and deliver compliance‑related training.
- Oversee recurring compliance reporting, ensuring accuracy, validation, and on‑time submission; collaborate with BI to define KPIs and system requirements.
- Act as a point of contact for health plans and delegated entities; support external audits, accreditation reviews, evidence preparation, and remediation efforts.
- Maintain strict adherence to HIPAA, privacy, security, and ethical standards; escalate and mitigate compliance risks appropriately.
- Collaborate across UM/CM, Quality, clinical teams, and other OSH programs to ensure coordinated workflows and a consistent, compliant care experience.
What are we looking for?
An ideal candidate will satisfy the following;
- Bachelor's degree in Healthcare Administration, Business, Public Health, Compliance, or related field (or equivalent experience).
- 3-5+ years of experience in healthcare compliance, delegation oversight, managed care, accreditation, or UM/CM operations.
- Preferred 1-3+ years of leadership experience (team lead, supervisor, or equivalent).
- Strong working knowledge of CMS, NCQA, Medicare/Medicaid, and state/federal regulatory requirements.
- Experience with auditing, root cause analysis, CAP/PIP management, and external audit readiness.
- Excellent communication skills with ability to break down complex regulatory requirements.
- Highly organized; able to manage multiple competing deadlines in a fast‑paced environment.
- Strong analytical and problem‑solving skills; proficiency in Excel/Google Sheets and EMR systems.
- Experience with NCQA delegated audits or health plan oversight.
- Prior experience in a health plan, MSO, IPA, or managed care organization.
- Demonstrated understanding of culturally responsive care
- Proven organizational and detail-orientation skills
- Ability to collaborate effectively with a staff, providers, and a diverse group of leaders.
- US work authorization
- Someone who embodies being Oaky
What does being "Oaky" look like?
- Radiating positive energy
- Assuming good intentions
- Creating an unmatched patient experience
- Driving clinical excellence
- Taking ownership and delivering results
- Being relentlessly determined
Why Oak Street Health?
Oak Street Health is on a mission to "Rebuild healthcare as it should be'', providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient's communities, and focused on the quality of care over volume of services. We're an organization on the move! With over 150 locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody "Oaky" values and passion for our mission.
Oak Street Health Benefits:
- Mission-focused career impacting change and measurably improving health outcomes for Medicare patients
- Paid vacation, sick time, and investment/retirement 401K match options
- Health insurance, vision, and dental benefits
- Opportunities for leadership development and continuing education stipends
- New centers and flexible work environments
- Opportunities for high levels of responsibility and rapid advancement
Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply.
Learn more at www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$46,988.00 - $112,200.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 03/17/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Job ID: 82917398
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