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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.

Qualifications

• 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.

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.

Company Description

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.