Senior Director, Regulatory Compliance
Company: L.A. Care Health Plan
Location: Los Angeles
Posted on: March 20, 2023
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Job Description:
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Administrative, HR, Business Professionals Department: - Compliance
Location: - Los Angeles, CA, US, 90017 Position Type: - Full Time
Requisition ID: - 9221 Salary Range: $149,502.00 -(Min.) -
-$189,732.00 -(Mid.) - -$254,152.00 -(Max.)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.
As a condition of employment, L.A. Care requires a COVID-19
vaccine. This requirement includes our remote workforce. If you
would like to request an exemption, L.A. Care has implemented a
process to consider exemptions for documented medical conditions
and sincerely held religious beliefs. L.A. Care will review all
exemption requests prior to proceeding with the recruitment
process.Job SummaryThe Senior Director serves as a senior leader
within the Compliance Department, leading compliance efforts across
all functions across L.A. Care. The Senior Director manages the
following compliance and regulatory functions, such as management
of external regulatory audits; including audit readiness and
corrective action plans; enterprise-wide compliance monitoring
strategies; including administrative and clinical; regulatory
agency management; including relationship and complaint management
with State and Federal regulatory agencies; regulatory reporting;
including design and implementation of quality assurance strategies
to ensure reports submitted to regulators are timely, complete, and
accurate, and Compliance Committee and Board of Governors
compliance reports, meetings and issue escalation. The Senior
Director develops and recommends strategic compliance initiatives
for L.A. Care, accountable to continuously streamline and improve
the overall effectiveness of the department.Directs all aspects of
running an efficient team, including hiring, supervising, coaching,
training, disciplining, and motivating
direct-reports.DutiesPrioritizes and manages day-to-day operations
of the Regulatory Affairs unit (Regulatory Audits, Monitoring,
Regulatory Agency Management, Governance, and Regulatory
Reporting). Develops goals, objectives and actions plans for
assigned staff which includes full management responsibility for
the hiring, performance reviews, salary reviews and disciplinary
matters for direct reporting employees.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. Builds, manages, motivates and develops
teams to monitor and drive consistent quality, efficiency and
enhanced solutions that meet the defined high-quality standards.
Prioritizes and manages day to day operations, including
supervision of a staff including but not limited to Directors,
Senior Managers, Advisors and Specialists, including hiring of
staff and evaluation of staff performance.Develops and recommends
of strategic plans, Regulatory Affairs, and Compliance Department
Operations. Monitors the day-to-day activities of L.A. Care to
further its compliance objectives; ensure compliance with laws,
rules, and regulations. Designs, implements, documents, and
maintains an enterprise-wide compliance monitoring program and
other specialized tools that clearly outline regulatory
requirements, detects and corrects non-compliance on an ongoing
basis, and drives ongoing remediation. Standardizes, centralizes,
and oversees all compliance monitoring activities. -Monitors the
performance of the L.A. Care Compliance Program on an ongoing
basis, taking appropriate steps to improve its effectiveness.
Communicate the importance of compliance to senior management, the
compliance committee, and health plan staff. Promote effective
lines of communication to and from the Compliance department.
Leads, facilitates or participates in relevant committees and
committees as Director determines or as assigned by the Chief
Compliance Officer and leadership team. -
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Manages all regulatory audits and readiness activities; including
mock audits, submission quality assurances, corrective action plan
development, approval, and monitoring. Manages and maintains
relations with regulators. This includes reviewing regulatory
inquiry trends, notices of non-compliance response, and
self-disclosures of non-compliance issues to the regulators.
-Develops and maintains productive relationships with all levels of
management, staff, and external stakeholders. Conduct periodic
enterprise training on prevention, detection, and correction of
non-compliance including but not limited to: compliance program
effectiveness, regulatory audits, root cause analysis, corrective
action plans, and regulatory submissions. -Manages all regulatory
reports and internal compliance reports. Designs and implements
report quality assurance processes to ensure timely, complete, and
accurate submissions. This includes, but is not limited to,
periodic live system reviews and data validation tests. Documents
and maintains regulatory reporting matrices and report submissions.
Communicates regulatory reporting requirements to the organization.
Facilitates cross-functional work groups to ensure regulatory
reporting processes are developed, documented, and reviewed by all
stakeholders. -Ensures organizational compliance with regulatory
requirements and effectively communicate to L.A. Care staff,
external contacts and regulatory agencies; Builds relationships
with regulatory agencies to communicate compliance activities and
deliverables.With the Chief Compliance Officer, organize the
Internal Compliance Committee (ICC), including developing
appropriate agendas, reports, and information requested by the
committee and/or Board. -Designs and implements goals and programs
that demonstrate strategic thinking focused on achieving
operational excellence within the department and with external
business partners. -Prepares and presents periodic reports
evaluating L.A. Care's compliance performance to the leadership
team, compliance committee, Chief Executive Officer (CEO) and Board
of Directors. -Perform other duties as assigned.Education Required
Bachelor's Degree In lieu of degree, equivalent education and/or
experience may be considered. Education Preferred Master's Degree
Experience
Required:
At least 8 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 6-8
years of supervisory/management experience.Experience designing,
implementing compliance programs, policies and practices; and/or
managing health plan/ managed care business operations. Demonstrate
progressive improvement in audit results over time.Strong
background and experience in cross-functional/team based approach
to problem solving.Skills
Required:
Excellent interpersonal, verbal, and written communication
skills.Knowledge of Word and Excel.Ability to drive strategic
vision to accelerate and enhance development of quality control
programs for business operations. Demonstrated ability to
brainstorm, develop and implement new compliance/audit
initiatives.
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Demonstrates significant leadership competencies, including
employee engagement, strategic thinking, thorough understanding how
to use and manage health care data.Demonstrates the ability to
mentor and train staff, including improving the capacity of staff
to achieve the highest levels of independent auditor performance
and business collaboration.Understanding of the vital importance of
commitment to excellence and demonstrating a high regard for
organizational values.Strong organization and planning skills and
be flexible to handle multiple assignments, changing priorities,
and meeting.Must be able to present findings to various levels of
management, across all organizations.Licenses/Certifications
RequiredLicenses/Certifications Preferred Certified HealthCare
Compliance (CHC) Certified Internal Auditor (CIA) Required
TrainingAdditional InformationSalary Range Disclaimer: The expected
pay range is based on many factors such as geography, experience,
education, and the market. The range is subject to change.L.A. Care
offers -a wide range of benefits including
Keywords: L.A. Care Health Plan, Los Angeles , Senior Director, Regulatory Compliance, Executive , Los Angeles, California
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