L.A. Care Health Plan
Compliance Advisor II
L.A. Care Health Plan, Los Angeles, California, United States, 90079
Compliance Advisor II
Job Category:
Administrative, HR, Business ProfessionalsDepartment:
ComplianceLocation:
Los Angeles, CA, US, 90017Position Type:
Full TimeRequisition ID:
11271Salary Range:
$77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (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.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.The Compliance Advisor II ensures L.A. Care business units are compliant with all Product Lines' contractual, state and federal regulatory, and accreditation requirements. The Compliance Advisor develops regulatory submissions, reports, agendas, and communications to the Internal Compliance Committee and the Compliance and Quality Committee of the Board of Governors and provides support for the management of external state and federal regulatory audits. The Compliance Advisor prepares executive summaries and reports, develops and conducts training activities for subordinates, peers, and L.A. Care business units, and participates in interdisciplinary/cross-functional teams.Duties
Analyze and interpret contractual, state and federal regulatory, and accreditation requirements.Participate in and conduct compliance functions, including developing compliance tools and validating implementation of new requirements and corrective action plans.Work with internal business units to prepare reports for distribution to internal Committees and external entities.Facilitate cross-functional teams to correct performance deficiencies.Prepare and conduct trainings for internal business units and/or external entities.Review, approve and suggest revisions on policies and procedures, member/provider materials, compliance work plans, etc.Work with internal business units to identify gaps, develop and implement corrective action plans, and facilitate monitoring activities to ensure compliance with regulatory requirements.Review internal and external inquiries and collaborate with management, business units, and Delegates to ensure timely, accurate, and complete submissions.Develop, maintain, and monitor Internal Compliance Committee (ICC) Charter, Compliance Program, and key performance indicators.Perform other duties as assigned.Education Required
Bachelor's Degree in Public Health or Related Field. In lieu of degree, equivalent education and/or experience may be considered.Education Preferred
Master's Degree in Public Health or Related Field.Experience
Required:
At least 3 years of experience in a managed care setting; experience in health care auditing and monitoring; demonstrated experience developing and delivering training programs.Preferred:
2 years of Medi-Cal, Medicare or commercial product compliance; regulatory change management and risk management experience.Skills
Required:
Excellent written and verbal communication skills; knowledge in health care compliance; ability to manage multiple priorities and projects; knowledge of Medi-Cal Managed Care principles.Preferred:
Advanced skills in Visio, PowerPoint and/or SharePoint.Licenses/Certifications Required
None specified.Licenses/Certifications Preferred
None specified.Required Training
None specified.Physical Requirements
LightAdditional Information
Salary 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:Paid Time Off (PTO)Tuition ReimbursementRetirement PlansMedical, Dental and VisionWellness ProgramNearest Major Market:
Los AngelesJob Segment:
Medicare, Medicaid, Internal Audit, Public Health, Risk Management, Healthcare, Finance
#J-18808-Ljbffr
Job Category:
Administrative, HR, Business ProfessionalsDepartment:
ComplianceLocation:
Los Angeles, CA, US, 90017Position Type:
Full TimeRequisition ID:
11271Salary Range:
$77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (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.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.The Compliance Advisor II ensures L.A. Care business units are compliant with all Product Lines' contractual, state and federal regulatory, and accreditation requirements. The Compliance Advisor develops regulatory submissions, reports, agendas, and communications to the Internal Compliance Committee and the Compliance and Quality Committee of the Board of Governors and provides support for the management of external state and federal regulatory audits. The Compliance Advisor prepares executive summaries and reports, develops and conducts training activities for subordinates, peers, and L.A. Care business units, and participates in interdisciplinary/cross-functional teams.Duties
Analyze and interpret contractual, state and federal regulatory, and accreditation requirements.Participate in and conduct compliance functions, including developing compliance tools and validating implementation of new requirements and corrective action plans.Work with internal business units to prepare reports for distribution to internal Committees and external entities.Facilitate cross-functional teams to correct performance deficiencies.Prepare and conduct trainings for internal business units and/or external entities.Review, approve and suggest revisions on policies and procedures, member/provider materials, compliance work plans, etc.Work with internal business units to identify gaps, develop and implement corrective action plans, and facilitate monitoring activities to ensure compliance with regulatory requirements.Review internal and external inquiries and collaborate with management, business units, and Delegates to ensure timely, accurate, and complete submissions.Develop, maintain, and monitor Internal Compliance Committee (ICC) Charter, Compliance Program, and key performance indicators.Perform other duties as assigned.Education Required
Bachelor's Degree in Public Health or Related Field. In lieu of degree, equivalent education and/or experience may be considered.Education Preferred
Master's Degree in Public Health or Related Field.Experience
Required:
At least 3 years of experience in a managed care setting; experience in health care auditing and monitoring; demonstrated experience developing and delivering training programs.Preferred:
2 years of Medi-Cal, Medicare or commercial product compliance; regulatory change management and risk management experience.Skills
Required:
Excellent written and verbal communication skills; knowledge in health care compliance; ability to manage multiple priorities and projects; knowledge of Medi-Cal Managed Care principles.Preferred:
Advanced skills in Visio, PowerPoint and/or SharePoint.Licenses/Certifications Required
None specified.Licenses/Certifications Preferred
None specified.Required Training
None specified.Physical Requirements
LightAdditional Information
Salary 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:Paid Time Off (PTO)Tuition ReimbursementRetirement PlansMedical, Dental and VisionWellness ProgramNearest Major Market:
Los AngelesJob Segment:
Medicare, Medicaid, Internal Audit, Public Health, Risk Management, Healthcare, Finance
#J-18808-Ljbffr