Compliance Advisor II
L.A. Care Health Plan
full-time
Posted on:
Location Type: Office
Location: Los Angeles • California • United States
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Salary
💰 $77,265 - $123,625 per year
About the role
- Ensure compliance of L.A. Care business units with all contractual, state and federal regulatory, and accreditation requirements.
- Develop regulatory submissions, reports, agendas and communications to the Internal Compliance Committee and Compliance and Quality Committee of the Board of Governors.
- Provide support for external regulatory audits.
- Prepare executive summaries and reports, and conduct training activities for business units.
- Investigate and manage teams in compliance-related activities.
- Work with internal business units to create reports, identify gaps, and develop corrective action plans.
Requirements
- Bachelor's Degree in Public Health or Related Field
- At least 3 years of experience in a managed care setting
- Experience in health care auditing and monitoring (preferably in Appeals, Grievances, Quality Improvement, Utilization Management (UM) and so forth) and developing audit tools.
- Demonstrated experience developing and delivering training programs and making presentations.
- 2 years of Medi-Cal, Medicare or commercial product compliance preferred.
- Regulatory change management and risk management experience in a health plan or hospital setting preferred.
- Working knowledge of California Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and Knox-Keene requirements preferred.
- Advanced skills in Visio, PowerPoint and/or SharePoint preferred.
Benefits
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
health care auditingmonitoringaudit toolsregulatory submissionscompliance-related activitiescorrective action plansregulatory change managementrisk management
Soft Skills
training program developmentpresentation skillsinvestigationteam management
Certifications
Bachelor's Degree in Public Health