L.A. Care Health Plan · 4 hours ago
Compliance Advisor II
Los Angeles, CA
Full-time
Onsite
Mid Level
$77K/yr - $124K/yr
3+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, dedicated to providing access to quality health care for vulnerable and low-income communities in Los Angeles County. The Compliance Advisor II ensures compliance with regulatory and accreditation requirements, develops reports, facilitates training, and supports the management of audits and compliance functions.
FitnessGovernmentHealth Care
Responsibilities
Analyze and interpret contractual, state and federal regulatory, and accreditation requirements
Participate in and conduct compliance functions, including, but not limited to, 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 including internal business units and/or external entities 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., as well as submit to regulatory entities for approval
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 all levels of organizational management, business units and our Delegates to ensure timely, accurate, and complete submissions. This includes self-disclosures of non-compliance issues to the regulators
Develop, maintain, and monitor Internal Compliance Committee (ICC) Charter, Compliance Program and key performance indicators. Responsible for the development of Board/committee write-ups to be presented at the Compliance & Quality (C&Q) and Internal Compliance Committee (ICC) meetings
Perform other duties as assigned
Qualification
Required
Bachelor's Degree in Public Health or Related Field
At least 3 years of experience in a managed care setting
Experience in health care auditing and monitoring (preferably in Appeals, Grievances, Quality Improvement, Utilization Management (UM) and so forth) and developing audit tools
Demonstrated experience developing and delivering training programs and making presentations
Excellent written and verbal communication skills
Knowledge in health care compliance
Ability to manage multiple priorities and projects and meet deadlines
Knowledge of Medi-Cal Managed Care principles and/or government programs
Working knowledge of California Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and Knox-Keene requirements, as well as highly developed analytical and critical thinking skills
Preferred
Master's Degree in Public Health or Related Field
2 years of Medi-Cal, Medicare or commercial product compliance
Regulatory change management and risk management experience and/or business continuity experience in a health plan or hospital setting preferred
Advanced skills in Visio, PowerPoint and/or SharePoint preferred
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
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