Deputy Chief Compliance Officer

Job Summary

The Deputy Chief Compliance Officer (DCCO) is responsible for advancing the strategic direction of the Compliance department and ensuring effective execution of L.A. Care Health Plan’s enterprise-wide compliance program. Acts as the department’s operational leader and oversees the day-to-day management, coordination, and integration of compliance functions across the organization.

The DCCO provides direct leadership to Regulatory Compliance, Delegation Oversight, Corporate Compliance Monitoring, and related program areas., Ensures alignment of these units with organizational priorities, evolving regulatory requirements, and the health plan’s strategic objectives.

Serves as the centralized executive leader for Delegation Oversight, accountable for overseeing all delegated functions across the enterprise.  Leads the transition to a standardized, compliance-led delegation oversight model that strengthens monitoring, auditing, reporting, and corrective action processes across all delegates.

In addition, the DCCO serves as the designated Medicare Compliance Officer (MCO), responsible for ensuring that L.A. Care’s Medicare Advantage operations comply with all Centers for Medicare & Medicaid Services (CMS) program requirements. This includes oversight of First Tier, Downstream, and Related Entities (FDRs); CMS audit readiness; HPMS memo implementation; Medicare training; and regulatory reporting.

As the second-in-command to the Chief Compliance Officer, the DCCO ensures continuity, resilience, and executive leadership across the compliance function. The role is a trusted advisor to senior leadership, the Board, and regulators on emerging risks, program performance, workforce planning, and infrastructure investment to sustain a strong, future-ready compliance framework. 

Duties

Provides executive continuity and leadership across the compliance function. Drives the development and execution of the enterprise compliance strategy, with emphasis on long-term planning, risk mitigation, organizational transformation, and governance effectiveness. Represents Compliance in executive forums, board committees, and regulatory engagements as delegated by the CCO, while strengthening and leading governance structures to ensure disciplined decision making and accountability at the highest levels.

Serves as the designated Medicare Compliance Officer under the Chief Compliance Officer and holds enterprise responsibility for Medicare program compliance. This includes oversight of CMS Program Integrity requirements, HPMS memo implementation, First Tier, Downstream, and Related Entity (FDR) management, and CMS audit preparedness and execution. Ensures all Medicare policies, training, and reporting obligations are consistently fulfilled, with a standard of continuous audit readiness.

Expands and centralizes leadership of Delegation Oversight across the entire organization, serving as the executive owner of all delegated oversight programs, including operations and clinically delegated activities. Ensures consistent standards for monitoring, auditing, corrective action, performance evaluation, and regulatory alignment across all delegates. Leads the transformation from decentralized oversight to a unified, compliance-led Delegation Oversight model built upon standardized methodologies, analytics, and governance.

From a regulatory perspective, provides executive leadership and accountability for adherence to the Knox-Keene Act, HIPAA, CMS requirements, DMHC and DHCS regulations, and all state and federal settlement agreements.

In partnership with cross functional leadership, ensures delegated entities meet contractual, regulatory, and performance requirements. Leads the development of standardized delegation tools, “baseball cards,” risk scoring methodologies, and enterprise-wide delegation monitoring frameworks. Oversees the accuracy and consistency of delegate reporting, including claims payment accuracy, credentialing timeliness and quality, QI program compliance, privacy safeguards, investigation and referral requirements, and UM decision-making standards.

Directs the design and execution of enterprise-wide monitoring, auditing, and corrective action programs; leads preparation and response for all external audits and examinations; and proactively identifies emerging areas of regulatory risk, driving mitigation strategies aligned with the organization’s risk appetite and long-term sustainability.

Performs other duties as assigned.

Duties Continued

Education Required

Education Preferred

Experience

Required:

At least 10 years of relevant compliance experience in healthcare industry.

At least 10 years of management experience in regulatory and compliance in healthcare, law, insurance or related field, and in managed care compliance.

Advanced experience overseeing large-scale delegated functions (Claims, Credentialing, QI, SIU, UM, Privacy, etc.), including monitoring, auditing, and corrective actions.

Preferred:

Experience with compliance technology platforms (GRC, monitoring dashboards, AI-driven oversight tools).

Skills

Required:

Deep expertise in CMS Medicare Advantage compliance requirements and experience serving as or supporting a Medicare Compliance Officer.

Ability to align operational and clinical processes with regulatory requirements to ensure seamless oversight of internal and delegated entities.

Expert strategic thinking, analytical, organizational, and planning skills.

Ability to influence with strong business and people leadership capabilities.   Excellent interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment

Ability to work and create structure in complex and ambiguous situations and respond flexibly in time sensitive situations.

Strong skills in organization, planning, prioritization and attention to detail.

Track record of delivering measurable improvements in operations.

Effective conflict resolution and negotiation management skills.

Demonstrated influencing skills.

Skills in planning, executing, and sustaining complex, enterprise-wide compliance initiatives.

Excellent communication skills to include written, verbal and presentation.

Strong knowledge of state (DMHC, DHCS) and federal regulatory frameworks impacting managed care.

Preferred:

Proven ability to manage audits, investigations, and regulatory engagements.

Expertise leading organizational redesign, governance realignment, and process standardization across divisions and delegates.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Additional Information