Compliance Manager

3 days ago

🏄 California – Remote

Although this job is listed in California, this company may be open to hiring remote in other states.

💵 $110k - $125k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

Apply Now

Receive Emails with Similar Jobs

Community Health Plan of Imperial Valley

WebsiteLinkedInAll Job Openings

Community Health Plan of Imperial Valley (CHPIV) is a locally managed public health care plan operating under the Medi-Cal Managed Care Program. Providing services primarily to members, providers, and residents of Imperial County, CHPIV focuses on reducing healthcare costs while maintaining high-quality care through managed care features like provider networks and wellness programs. The organization collaborates with Health Net to ensure a robust network of healthcare providers, aiming to deliver exceptional healthcare to its members.

11 - 50 employees

Founded 2023

⚕️ Healthcare Insurance

👥 B2C

🧘 Wellness

📋 Description

• Oversees regulatory compliance activities including regulatory audits and regulatory reports • Supervise the Compliance Advisor and provide mentorship and guidance. • Develop and deliver comprehensive compliance training programs for employees, management, and relevant stakeholders, promoting a culture of compliance awareness and ethical conduct throughout the organization. • Work closely with the Senior Director of Compliance to develop strategies for effectively managing the Regulatory Compliance team. • Provide strategic guidance to internal business units and delegates to identify gaps, develop and implement corrective action plans and facilitate monitoring activities to ensure compliance with regulatory requirements. • Develop, maintain, and monitor Compliance & Policy Committee (CPC) Charter, Compliance Program and key performance indicators. • Responsible for the development of Board/committee write-ups to be presented at Compliance Committees and other committees as needed. • Take a leading role in managing external state and federal regulatory audits, ensuring compliance and addressing any issues that arise. • Develop and implement comprehensive regulatory audit readiness programs, such as conducting mock audits to proactively identify and address potential compliance gaps. • Coordinate audit preparation activities, facilitate audit responses, and ensure that all regulatory requirements are met. • Monitor and evaluate the effectiveness of the Compliance Program, making improvements as necessary to ensure optimal performance and regulatory adherence. • Prepare and present regular reports on compliance activities, risks, and outcomes to the senior leadership team, providing insights and recommendations for continuous improvement. • Liaise with external regulatory bodies and industry groups to stay current with compliance trends, changes in legislation, and best practices, and integrate this knowledge into the organization's compliance framework. • Lead the development and implementation of risk assessment methodologies to identify, analyze, and mitigate potential compliance risks.

🎯 Requirements

• Bachelor’s degree in public health or health care management from an accredited college or university; or equivalent education/experience in related area. • 5+ years of experience working in the compliance function in a Medi-Cal managed care setting • Knowledge of Medi-Cal Managed Care principles • Working knowledge of DHCS and Knox-Keene requirements, as well as highly developed analytical and critical thinking skills, to serve as a resource to internal business units and delegates.

🏖️ Benefits

• Health, dental, and vision insurance • Paid time off • A 401k plan with a generous match