Compliance Advisor, Regulatory Audits and Governance

Job Category:  Administrative, HR, Business Professionals
Department:  Compliance (145)
Location:  Los Angeles HQ, California, US
Position Type:  Full Time
Requisition ID:  473

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

DUTIES
The Advisor ensures that L.A. Care business units are compliant with all Product Lines' contractual, state and federal regulatory, and accreditation requirements. The Advisor will develop regulatory reports, agendas, minutes and communications to the Internal Compliance Committee and the Compliance and Quality Committee of the Board of Governors and provide support for the management of external state and federal regulatory audits. The Advisor will prepare executive summaries and reports, develop and conduct training activities for subordinates, peers and L.A. Care business units and lead or participate in interdisciplinary/cross-functional teams. The Advisor may investigate, assist with coordination and management of teams and work groups, project documentation and workflows, draft and complete presentations, auditing and monitoring of performance standards, and other duties as assigned. Although the Advisor's primary responsibility is providing support and leadership for regulatory audits and governance reports to the Internal Compliance Committee and the Compliance and Quality Committee of the Board of Governors, the Advisor will also advise and support the Senior Manager and the Chief Compliance Officer on other duties as assigned to support the mission and responsibilities of the Compliance Department and to support the business operations of L.A. Care Health Plan.

QUALIFICATIONS AND REQUIREMENTS

EDUCATION 
Required
High School Diploma

Preferred
Master's Degree

EXPERIENCE
Required
With High School Diploma: 6-8 years of managed healthcare experience; at least 1 year experience in regulatory audits and governance.
Experience in translating regulatory audit guidelines.
Working knowledge of DHCS, CMS, and NCQA requirements,
Demonstrated experience developing and delivering training programs and making presentations to internal staff and providers.

Preferred:
With Master's Degree: 2 years of managed healthcare experience; at least 1 year experience in regulatory audits and governance.

With Bachelor's Degree: 3-5 years of managed healthcare experience; at least 1 year experience in regulatory audits and governance.

With Associate's Degree: 5 years of managed healthcare experience; at least 1 year experience in regulatory audits and governance.

L.A. Care offer a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program


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