L.A. Care Health Plan · 18 hours ago
Deputy Chief Compliance Officer
Los Angeles, CA
Full-time
Onsite
Director/Executive
$206K/yr - $351K/yr
10+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, focused on providing health coverage to low-income residents of Los Angeles County. The Deputy Chief Compliance Officer (DCCO) is responsible for leading the Compliance department and ensuring effective execution of the enterprise-wide compliance program, overseeing various compliance functions and serving as the Medicare Compliance Officer.
FitnessGovernmentHealth Care
Responsibilities
Provides executive continuity and leadership across the compliance function
Drives the development and execution of the enterprise compliance strategy, with emphasis on long-term planning, risk mitigation, organizational transformation, and governance effectiveness
Represents Compliance in executive forums, board committees, and regulatory engagements as delegated by the CCO, while strengthening and leading governance structures to ensure disciplined decision making and accountability at the highest levels
Serves as the designated Medicare Compliance Officer under the Chief Compliance Officer and holds enterprise responsibility for Medicare program compliance
This includes oversight of CMS Program Integrity requirements, HPMS memo implementation, First Tier, Downstream, and Related Entity (FDR) management, and CMS audit preparedness and execution
Ensures all Medicare policies, training, and reporting obligations are consistently fulfilled, with a standard of continuous audit readiness
Expands and centralizes leadership of Delegation Oversight across the entire organization, serving as the executive owner of all delegated oversight programs, including operations and clinically delegated activities
Ensures consistent standards for monitoring, auditing, corrective action, performance evaluation, and regulatory alignment across all delegates
Leads the transformation from decentralized oversight to a unified, compliance-led Delegation Oversight model built upon standardized methodologies, analytics, and governance
From a regulatory perspective, provides executive leadership and accountability for adherence to the Knox-Keene Act, HIPAA, CMS requirements, DMHC and DHCS regulations, and all state and federal settlement agreements
In partnership with cross functional leadership, ensures delegated entities meet contractual, regulatory, and performance requirements
Leads the development of standardized delegation tools, 'baseball cards,' risk scoring methodologies, and enterprise-wide delegation monitoring frameworks
Oversees the accuracy and consistency of delegate reporting, including claims payment accuracy, credentialing timeliness and quality, QI program compliance, privacy safeguards, investigation and referral requirements, and UM decision-making standards
Directs the design and execution of enterprise-wide monitoring, auditing, and corrective action programs; leads preparation and response for all external audits and examinations; and proactively identifies emerging areas of regulatory risk, driving mitigation strategies aligned with the organization’s risk appetite and long-term sustainability
Performs other duties as assigned
Qualification
Required
Master's Degree in Healthcare Administration or Related Field
At least 10 years of relevant compliance experience in healthcare industry
At least 10 years of management experience in regulatory and compliance in healthcare, law, insurance or related field, and in managed care compliance
Advanced experience overseeing large-scale delegated functions (Claims, Credentialing, QI, SIU, UM, Privacy, etc.), including monitoring, auditing, and corrective actions
Deep expertise in CMS Medicare Advantage compliance requirements and experience serving as or supporting a Medicare Compliance Officer
Ability to align operational and clinical processes with regulatory requirements to ensure seamless oversight of internal and delegated entities
Expert strategic thinking, analytical, organizational, and planning skills
Ability to influence with strong business and people leadership capabilities
Excellent interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment
Ability to work and create structure in complex and ambiguous situations and respond flexibly in time sensitive situations
Strong skills in organization, planning, prioritization and attention to detail
Track record of delivering measurable improvements in operations
Effective conflict resolution and negotiation management skills
Demonstrated influencing skills
Skills in planning, executing, and sustaining complex, enterprise-wide compliance initiatives
Excellent communication skills to include written, verbal and presentation
Strong knowledge of state (DMHC, DHCS) and federal regulatory frameworks impacting managed care
Certified HealthCare Compliance (CHC)
Preferred
Experience with compliance technology platforms (GRC, monitoring dashboards, AI-driven oversight tools)
Proven ability to manage audits, investigations, and regulatory engagements
Expertise leading organizational redesign, governance realignment, and process standardization across divisions and delegates
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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