Compliance Manager

Summary

Join the Central California Alliance for Health as the Compliance Manager, leading a team and reporting to the Compliance Director. Manage the Compliance function, act as a subject matter expert, maintain and monitor the Compliance Plan, and provide guidance. Responsibilities include managing the Risk Assessment and Internal Audit and Monitoring Program, regulatory audit support, and external regulatory audit functions. You will also manage, lead, supervise, mentor, and train staff. The ideal candidate is proactive, adaptable, and experienced in risk assessment, delegate oversight, auditing, and NCQA standards. This is a hybrid work environment with some in-office presence potentially required.

Requirements

• Knowledge of principles and techniques associated with healthcare compliance functions
• Knowledge of principles and practices of health care planning and administration
• Knowledge of healthcare regulatory policies
• Knowledge of methods and techniques of research, analysis, and reporting
• Knowledge of Medi-Cal, Medicare, Public Assistance and/or Social Security programs
• Ability to train, mentor, supervise, and evaluate the work of staff, promote an atmosphere of teamwork and cooperation, and motivate staff to achieve goals and objectives
• Ability to develop work plans and workflows, organize and prioritize Compliance activities
• Ability to act as a technical resource and interpret, apply and explain complex principles, policies, procedures, regulations, terms, processes, and programs related to area of assignment
• Ability to provide leadership, facilitate and lead meetings and projects, and guide employees in the resolution of issues
• Ability to manage the development and implementation of projects, systems, programs, policies, and procedures
• Bachelor’s degree in Business or Public Administration, Health Care Administration, Public Policy, or a related field and a minimum of six years of compliance-related experience in the healthcare industry which included some lead or supervisory responsibility (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

Responsibilities

• Manage the Compliance function
• Act as a subject matter expert
• Maintain and monitor the Compliance Plan
• Provide guidance on Compliance functions and departmental operations in a proactive and collaborative manner
• Manage the Risk Assessment and Internal Audit and Monitoring Program
• Provide regulatory audit support
• Manage the Alliance’s external regulatory audit functions and the Delegate Oversight Program
• Manage, lead, supervise, mentor, and train assigned staff

Preferred Qualifications

• Is proactive; takes initiative and works effectively with others to achieve common goals
• Is open to learning new technologies, particularly in AI software and workflow automation
• Is adaptable to change, and new processes, with the ability to lead in a dynamic, evolving environment
• Has experience with Risk Assessing, Delegate Oversight, Auditing, Monitoring and NCQA standards
• Is comfortable handling difficult conversations, adjusting communication style to different personalities, and audiences within the organization
• Has experience in public speaking and facilitating group interactions, with the ability to engage both small and large audiences effectively
• Works well as part of a team, fostering collaboration and maintaining open, proactive communication

Benefits

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations