Loading...

Senior Director, Risk Management and Operations Support

Job Category:  Management/Executive
Department:  Compliance
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  6161

 

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.

Job Summary

The Senior Director, Risk Management and Operations Support will manage three sub-units: Risk Management/Business Continuity-Disaster Recovery (including pandemic, earthquake and other preparedness planning);  Material review, including regulatory oversight of member and other material;  Regulatory analysis and implementation, including oversight, analysis and communication of regulatory changes.  The Senior Director 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 teams.    Although the Senior Director’s primary responsibility is management of the Risk Management and Operations Support unit, the Senior Director will also advise and support 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.

Duties

Prioritize and manage day to day operations.  Develops and mentors staff to build a culture of excellence. Responsible for organization structure and sourcing decisions and all people management activities including hiring, training and onboarding, goal setting and performance management.  Build, manage, motivate and develop teams to monitor and drive consistent quality, efficiency and enhanced solutions that meet the defined high-quality standards.

 

Manage risk management and operational oversight through annual risk assessment development and mitigation/monitoring activities, monitoring completion of corrective action plans; management of marketing and member material oversight and fulfillment; management of analysis of regulatory changes, communication and implementation, management of business continuity and disaster recovery initiatives and manage Compliance Department liaisons with business units.

 

Supports the Chief Compliance Officer in development of strategic plans for improvement of Compliance Department Operations.

  
Develops policies and procedures for assigned services areas.  Ensures desk level procedures and other documentation are developed and reviewed.

 

Conduct periodic enterprise training regarding risk management and operational oversight.

 

Serve on internal committees and workgroups. Lead, facilitate or participate in relevant committees and committees as assigned by the Chief Compliance Officer.

 

Ensure compliance with all regulatory agency contract requirements regarding reporting of cases under risk management and operational oversight.

 

Perform other duties as assigned.

Education Required
Bachelor's Degree in Business Administration or Related Field
In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred
Master's Degree
Juris Doctor Degree or Doctor of Law Degree (J.D.)
Experience

Required:
At least 8-10 years of progressive health care compliance and/or audit experience including extensive experience in compliance or auditing in health care or another highly regulated industry.

 

At least 8 years of supervisory/management exerience. 

Skills

Required:
High level of tact and ability to communicate complex and potentially sensitive issues to various levels of management. Excellent presentation, relationship building and interaction skills. 

 

Demonstrated project management, organization and facilitation skills.

 

Strategic thinker with business risk awareness and outstanding analytical and problem-solving capabilities.

 

Ability to analyze data and unique situations, determine errors and potential problems arising from the analyses, and formulate practical and workable solutions to problems identified.

 

Ability to effectively prioritize and execute tasks in a high-pressure environment.

 

High level of personal integrity, and the ability to professionally handle confidential matters and exude the appropriate level of judgment and maturity.

 

Must be able to work effectively with all levels of management and manage interdisciplinary projects and teams.

 

Knowledge of health plan management, compliance, finance, accounting, assurance and control principles.

 

Knowledge of Medicare, Medi-Cal, and managed care regulations and regulatory environments.

Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Additional Information

 

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

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