Job Information
L.A. Care Health Plan Managing Advisor III Senior Director, Policy and Regulatory Compliance (ALD) in Los Angeles, California
Managing Advisor III Senior Director, Policy and Regulatory Compliance (ALD)
Job Category: Administrative, HR, Business Professionals
Department: Compliance
Location:
Los Angeles, CA, US, 90017
Position Type: Full Time
Requisition ID: 12162
Salary Range: $171,925.00 (Min.) - $232,100.00 (Mid.) - $292,274.00 (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, we make sure our members 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 residents and to support the safety net required to achieve that purpose.
Job Summary
The Managing Advisor III Senior Director, Compliance Policy and Regulatory is responsible for directing and overseeing the implementation of LA Care’s health compliance strategies to ensure compliance with the Medi-Cal regulations and alignment with the organization’s strategic goals.
This Managing Advisor III position collaborates with L.A. Care Senior Leadership team (SLT), Compliance team leaders, Compliance and Quality Committee members, governmental agencies, healthcare providers, and community stakeholders to advocate for compliance strategies that improve access, quality, and sustainability of Medi-Cal services, Covered California, and D-SNP.
Additionally, this position works closely with the SLT for ensuring Compliance has appropriate stakeholder engagement and alerts the Chief Compliance Officer of any issues and risks not being addressed or mitigated. The advisor supports the execution of the Annual Compliance Work Plan and provide the necessary support to seek completion of key activities in Compliance.
This position collaborates with key stakeholders to review programs, projects, processes, procedures, and policies; and to conduct end-to-end root cause analysis to enhance and improve outcomes and remediate issues to comply with the national and statewide standards and regulations.
Provides leadership in the ongoing development and implementation of processes and protocols that are responsive to organizational needs. This position is responsible for directing all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.
Duties
Policy Development and Implementation: Lead the development of health policies related to Medi-Cal services, ensuring alignment with state and federal regulations and the mission of the local health plan.
Regulatory Compliance: Ensure the health plan adheres to Medi-Cal and related healthcare regulatory standards, including timely implementation of legislative and policy changes.
Advocacy and Representation: Provides expert advice to various business units on relevant topics within the organizational standards, national and state-wide compliance. Serve as the primary representative for the health plan in discussions with state and federal agencies, including the Department of Health Care Services (DHCS), legislators, and other stakeholders.
Government Relations: Develop and maintain relationships with key policymakers and advocacy groups to influence health policy in support of the organization’s goals.
Strategic Planning: Acts as the point of contact for key strategic initiatives and utilize appropriate resources to meet current and future departmental and Enterprise-wide goals. In addition, provide oversight and direction on new projects and initiatives, monitoring key performance indicators (KPIs) to measure the effectiveness of implemented changes and adjust strategies as needed. Work closely with the executive leadership team to integrate policy considerations into the organization’s strategic plans, ensuring policies promote improved patient outcomes and operational efficiencies. Ensure L.A. Care and Compliance Goals tie back to enterprise-wide business functions and processes. Address underlying strategic and tactical objectives affecting compliance with internal and governmental policies. Ensure enterprise-wide business functions and processes are effectively and efficiently administered and adapted to meet L.A. Care’s strategic and annual goals.
Stakeholder Engagement: Lead efforts to engage and collaborate with healthcare providers, advocacy groups, and community organizations to support the implementation of Medi-Cal policies.
Duties Continued
Policy Research and Analysis: Develops reports, analyzes data, and provides presentation on status of areas of responsibilities on an as needed basis in support of department operations. Oversee research and analysis of emerging health policy trends, legislation, and regulatory changes that could impact the local Medi-Cal plan and its beneficiaries. Conducts research and analysis of business performance and improvements with key stakeholders to document current state, identify gaps and present remediation plan/options to leadership. Leads the implementation of initiatives and monitor for successful outcomes.
Communication and Education: Partners with key management to communicate compliance and operational priorities and provide feedback or follow-ups to key stakeholders. Ensure clear and consistent communication regarding policy changes and compliance requirements across all levels of the organization, as well as with external partners. Conduct peer and quality assurance reviews to ensure reporting quality and integrity of compliance data.
Leadership and Team Management: Lead a team of policy experts, ensuring effective policy analysis, strategy development, and advocacy efforts are implemented to advance the goals of the health plan. Responsible for the work and related budget of department programs. Responsible for consolidating the budget of the department’s programs and coordinate with the Department’s Senior Management on annual budgeting and monthly variance follow-ups. Develops goals, objectives and actions plans for assigned staff which includes full management responsibility for the hiring, performance reviews, salary reviews and disciplinary matters for direct reporting employees.
Education Required
Bachelor's Degree in Public Health or Related Field
Education Preferred
Master's Degree in Public Health or Related Field
Experience
Required:
At least 9 years of experience in healthcare policy, government relations, or regulatory affairs, preferably in a Medi-Cal or Medicaid environment.
At least 8 years of experience leading, supervising or managing a staff.
Experience in working with state and federal healthcare regulatory agencies.
Experience and Proven track record of successfully advocating for health policy initiatives.
Preferred:
Experience with California’s Medi-Cal programs and public health systems.
Experience in a Partner, Managing Director, General Manager, Executive/Managing Director, Director/Sr Manager level management consulting capacity.
Experience in Departmental / Product implementation (Projects, Affordable Care Act (ACA) Marketplace, Medicaid, or Medicare product)
Skills
Required:
Strong understanding of Medi-Cal regulations, healthcare policy, and public health issues in California.
Excellent strategic thinking, leadership, and decision-making skills.P
Strong communication and relationship-building abilities, with experience working with diverse stakeholders.
Ability to navigate complex regulatory environments and advocate effectively for policy change.
Exceptional knowledge of finance with the ability to make strategic financial decisions, understand financial implications, and manage budgets.
Excellent organization skills.
Proficiency with Microsoft Office applications (Word, Excel, Access, PowerPoint, Visio).
Ability to collaborate with cross-functional teams and influence decision-making.
Preferred:
Demonstrated skills and capability in establishing relationships with policymakers,5 regulators, c-suite leaders, and advocacy groups in the healthcare field.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
Light
Additional Information
Additional Essential Duties and Responsibilities :
Collaboration and Cross-Functional Support: Interact with senior management, decision makers, and governmental officials on current and future program initiatives. Work closely with executive and senior management and cross-functional teams to integrate compliance risk management. Provide expert guidance to internal stakeholders on compliance and regulatory policies.
Reporting and Communication: Develop and deliver regular quarterly reports on stakeholder engagement. Communicate cross-departmental compliance risk issues and mitigation plans effectively to both internal and external audiences. Provide updates on Compliance Workplan completeness.
Perform other duties as assigned.
This role may require occasional travel to Sacramento and the ability to manage multiple time-sensitive projects.
Preferred:
Master’s degree in MPH or MPA from a top 25 school in Health Policy and Administration
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.
This position is a limited duration position. The term of this position is a minimum one year and maximum of two years from the start date unless terminated earlier by either party. Limited duration positions are full-time positions and are eligible to receive full benefits.
L.A. Care offers a wide range of benefits including
Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)