Compliance Advisor III

Compliance Advisor III

Job Category:
Administrative, HR, Business Professionals

Department:
Compliance

Location:

Los Angeles, CA, US, 90017

Position Type:
Full Time

Requisition

Salary Range: $88,854.00 (Min.) – $ (Mid.) – $ (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, ensuring they get the right care at the right place at the right time.

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 to support the safety net required to achieve that purpose.

The Compliance Advisor III ensures that the Plan’s processes and operations are compliant with all state and federal regulatory requirements, including CMS, DHCS, and DMHC. The Advisor III is responsible for developing and leading initiatives related to regulatory deliverables, reporting, analysis and implementation, audits, corrective action plans, regulator communications, and workflow improvements. The Advisor III leads cross‑functional teams and communicates updates, challenges, and risks to leadership via verbal and written reporting, serving as a Subject Matter Expert and assisting business units in operational decision‑making within regulatory constraints.

• 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 business units; provide recommendations as needed.
• Develop processes and specialized tools to monitor compliance performance and support regulatory deliverables; perform quality assurance checks on regulatory reports and written submissions.
• Identify enterprise‑wide issues and risks, recommend remediation plans, and oversee completion; escalates risks to Compliance management and the Chief Compliance Officer.
• Prepare the organization for regulatory audits by developing work plans, implementing readiness activities, identifying risks, and liaising with regulators.
• Drive continuous improvement by recommending compliance process improvements and implementing key programs; support all Compliance units and create efficient workflows.
• Provide written and verbal status reports to Compliance leadership and committees.
• Develop and conduct training on unit processes for lower‑tiered positions; provide mentorship and specialized knowledge to junior staff and interns.
• Perform other duties as assigned.

Bachelor’s Degree in Business Administration or a related field. In lieu of a degree, equivalent education and/or experience may be considered.

• Master’s Degree in Business Administration or a healthcare related field.
• Juris Doctor or Doctor of Law Degree (J.D.).

• Required: At least 5 years of healthcare related experience, with a minimum of 3 years in a managed care setting. Experience must include working knowledge of DHCS, DMHC, CMS, and NCQA requirements, as well as developing and delivering training programs and making presentations.
• Preferred: 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.

• Required: Knowledge of health care compliance; 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; ability to manage multiple priorities and meet deadlines; ability to develop training programs and make presentations.
• Preferred: Advanced skills in Excel, Visio, PowerPoint, and SharePoint.

• Certified Health Care Compliance (CHC)

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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 Reimbursement
• Retirement Plans
• Medical, Dental and Vision
• Wellness Program

Nearest Major Market: Los Angeles
Job Segment: Medicare, Medicaid, Risk Management, Healthcare, Finance