L.A. Care Health Plan · 15 hours ago
Compliance Advisor III
Los Angeles, CA
Full-time
Onsite
Senior Level
$89K/yr - $142K/yr
5+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, dedicated to providing health coverage to low-income residents of Los Angeles County. The Compliance Advisor III is responsible for ensuring compliance with state and federal regulations, leading initiatives related to regulatory deliverables, and serving as a Subject Matter Expert to assist business units in operational decision-making.
FitnessGovernmentHealth Care
Responsibilities
Serve as a lead Advisor within the department and conduct applicable departmental trainings
Manage competing priorities and tight regulatory deadlines
Research, analyze, and clearly communicate regulatory requirements/deliverables to applicable business units
Provide recommendations from a compliance perspective, as needed
Serve as a Subject Matter Expert for the rest of the organization and provide guidance on a wide array of compliance matters; assist business units in making decisions to ensure compliance with regulations
Prepare and conduct compliance-related trainings for internal business units and/or external entities
Lead initiatives by developing and ensuring timely, thorough completion of cross-functional work plans and by leading workgroups
Develop processes and specialized tools to monitor compliance performance and support regulatory deliverables
Perform quality assurance checks on regulatory reports and written submissions by developing review tools
Identify enterprise-wide issues and risks, recommend remediation plans, and oversight through to completion
Escalate risks to Compliance management and the Chief Compliance Officer
Prepare the organization for regulatory audits by developing work plans, implementing audit readiness activities, identifying risks, and liaising with regulators
Proactively drive continuous improvement by recommending compliance process improvement opportunities and implementing key Compliance Program activities
Support all Compliance units in implementing the Plan’s compliance program
Create workflows and drive efficiency within the Compliance department
Provide written and verbal status reports to Compliance Leadership and Committees
As a Subject Matter Expert, develop and conduct training on unit processes, for lower-tiered positions
Applies subject expertise in evaluating business operations and processes
Identifies areas where technical solutions would improve business performance
Consults across business operations, providing mentorship, and contributing specialized knowledge
Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices
Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed
Perform other duties as assigned
Qualification
Required
Bachelor's Degree in Business Administration or Related Field
At least 5 years of healthcare related experience, with a minimum of 3 years in a managed care setting
Experience to have working knowledge of Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Centers for Medicare and Medicaid Services(CMS) and National Committee for Quality Assurance (NCQA) requirements
Demonstrated experience developing and delivering training programs and making presentations
Knowledge in health care compliance
Must possess a strong understanding of Medi-Cal and Medicare laws and regulations and other state programs
Highly developed analytical and critical thinking skills
Excellent Written And Verbal Communication Skills Are Essential
Ability to manage multiple priorities and projects and meet deadlines
Ability to develop training programs and make presentations to unit and organization staff, including Leadership
Persuasion Skills
Working knowledge of DHCS, DMHC and CMS regulatory requirements
Certified HealthCare Compliance (CHC)
Preferred
Master's Degree in Business Administration or Healthcare Related Field
Juris Doctor Degree or Doctor of Law Degree (J.D.)
Supervisory experience and/or project management experience
At least 2 years of regulatory change, policy, or risk management experience for a health plan or healthcare system
Advanced skills in Excel, Visio, PowerPoint and SharePoint
Benefits
Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)
Company
L.A. Care Health Plan
L.A. Care’s mission is to provide access to quality health care for L.A.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Melanie Rainer
Chief Strategy and Transformation Officer
Recent News
2026-01-17
MarketScreener
2025-08-27
Company data provided by crunchbase