Compliance Advisor III
L.A. Care Health Plan
full-time
Posted on:
Location Type: Office
Location: Los Angeles • California • United States
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Salary
💰 $88,854 - $142,166 per year
About the role
- Ensure that the Plan’s processes and operations are compliant with state and federal regulatory requirements
- Develop and lead key initiatives related to regulatory deliverable submissions, regulatory reporting, regulatory analysis and implementation, regulatory audits, corrective action plans, regulator communications, and department processes/workflows
- Lead cross-functional teams and workgroups
- Communicate updates, challenges, and risks to leadership through verbal and written reporting
- Serve as a Subject Matter Expert for the organization
- Assist business units in operational decision-making in accordance with regulatory requirements
- Conduct applicable departmental trainings
- Manage competing priorities and tight regulatory deadlines
- Research, analyze, and clearly communicate regulatory requirements/deliverables to applicable business units
- Provide recommendations from a compliance perspective
- Prepare and conduct compliance-related trainings for internal business units and/or external entities
- Develop processes and specialized tools to monitor compliance performance and support regulatory deliverables
- Perform quality assurance checks on regulatory reports and written submissions
- Identify enterprise-wide issues and risks and recommend remediation plans
- Prepare the organization for regulatory audits
- Proactively drive continuous improvement by recommending compliance process improvement opportunities
Requirements
- Bachelor's Degree in Business Administration or Related Field
- In lieu of degree, equivalent education and/or experience may be considered
- At least 5 years of healthcare related experience, with a minimum of 3 years in a managed care setting
- Working knowledge of Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Centers for Medicare and Medicaid Services (CMS) and National Committee for Quality Assurance (NCQA) requirements
- Demonstrated experience developing and delivering training programs and making presentations
- Preferred: Supervisory experience and/or project management experience
- At least 2 years of regulatory change, policy, or risk management experience for a health plan or healthcare system
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
regulatory reportingregulatory analysisregulatory auditscorrective action planscompliance performance monitoringquality assurancetraining program developmentpolicy managementrisk management
Soft Skills
leadershipcommunicationcross-functional team collaborationoperational decision-makingtime managementproblem-solvingcontinuous improvement