Senior Manager, Compliance (Risk Management)

Job Category:  Management/Executive
Department:  Compliance (145)
Location:  Los Angeles HQ, California, US
Position Type:  Full Time
Requisition ID:  465

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.

Working under the direction of the Senior Director, Risk Management and Operations Oversight, this position will assist in the development and implementation of the enterprise risk management ("ERM") program, operations oversight and related initiatives. This position will collaborate with business and product leaders across the enterprise to promote a clear understanding of the ERM framework and the related accountability designations.  The Senior Manager will support the implementation of a formal risk and controls framework, including the design and implementation of key risk indicators, tools and systems, processes and controls and training, to effectively identify and manage risks across the enterprise.

QUALIFICATIONS & REQUIREMENTS

EDUCATION
Required:
High School Diploma

Preferred:
Master's Degree

EXPERIENCE
Required:
With High School Diploma:  10+ years of health care related experience designing, implementing compliance programs, policies and practices: and/or managed health plan/managed care business operations with 3 years of progressive management experience

Experience with implementing or supporting the implementation of managed Medicare, Medicaid or commercial regulations.
Strong organizational and planning skills, including flexibility to handle multiple assignments, changing priorities, and compressed deadlines.
Proficient in MS Office, including with Word and Excel.
Excellent interpersonal, verbal and written communication skills, including to senior management.
Must function well in team and matrixed work environment, collaborating effectively with team members and other departments:  1) Applying Generally Accepted Government Auditing Standards (GAGAS) for risk assessment; 2) Evaluating business process, compliance, and risk issues; 3) Leveraging creative thinking, individual initiative, and flexibility in prioritizing and completing tasks; and 4) Utilizing project management skills and principles in relation to managed care projects involving Medi-Cal, Medicare, large/small group, and individual products as well as data management projects, including developing project plans, budgets, and deliverable schedules.

Preferred:
With Associate's Degree:  8 years of health care related experience designing, implementing compliance programs, policies and practices: and/or managed health plan/managed care business operations with 3 years of progressive management experience

With Bachelor's Degree:  5 to 7 years of health care related experience designing, implementing compliance programs, policies and practices: and/or managed health plan/managed care business operations with 3 years of progressive management experience

With Master's Degree:  3 years of health care related experience designing, implementing compliance programs, policies and practices: and/or managed health plan/managed care business operations with 3 years of progressive management experience

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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