Compliance Manager

Community Health Plan of Imperial Valley (CHPIV) is Imperial County's Medi-Cal managed care plan. We are a locally managed public health care plan committed to working with members, providers, and the residents of Imperial County.

As we continue to build something great, we are looking for a Compliance Manager to lead the compliance program at CHPIV.

Our next team member will do the following:

• Oversees regulatory compliance activities including regulatory audits and regulatory reports
• Supervise the Compliance Advisor and provide mentorship and guidance
• Develop and deliver comprehensive compliance training programs for employees, management, and relevant stakeholders, promoting a culture of compliance awareness and ethical conduct throughout the organization.
• Develop and deliver compliance training programs for employees, management, and relevant stakeholders. Promote a culture of compliance awareness and ethical conduct throughout the organization.
• Work closely with the Senior Director of Compliance to develop strategies for effectively managing the Regulatory Compliance team
• Provide strategic guidance to internal business units and delegates to identify gaps, develop and implement corrective action plans and facilitate monitoring activities to ensure compliance with regulatory requirements.
• Develop, maintain, and monitor Compliance & Policy Committee (CPC) Charter, Compliance Program and key performance indicators. Responsible for the development of Board/committee write-ups to be presented at Compliance Committees and other committees as needed
• Take a leading role in managing external state and federal regulatory audits, ensuring compliance and addressing any issues that arise. Develop and implement comprehensive regulatory audit readiness programs, such as conducting mock audits to proactively identify and address potential compliance gaps. Coordinate audit preparation activities, facilitate audit responses, and ensure that all regulatory requirements are met
• Monitor and evaluate the effectiveness of the Compliance Program, making improvements as necessary to ensure optimal performance and regulatory adherence
• Prepare and present regular reports on compliance activities, risks, and outcomes to the senior leadership team, providing insights and recommendations for continuous improvement
• Liaise with external regulatory bodies and industry groups to stay current with compliance trends, changes in legislation, and best practices, and integrate this knowledge into the organization's compliance framework
• Lead the development and implementation of risk assessment methodologies to identify, analyze, and mitigate potential compliance risks
  
  

You may be right for this job if you have the following:

• Bachelor’s degree in public health or health care management from an accredited college or university; or equivalent education/experience in related area
• 5+ years of experience working in the compliance function in a Medi-Cal managed care setting
• Knowledge of Medi-Cal Managed Care principles
• Working knowledge of DHCS and Knox-Keene requirements, as well as highly developed analytical and critical thinking skills, to serve as a resource to internal business units and delegates
  
  

Our commitment to you:

• A competitive salary of $110,000-$125,000/ year
• Health, dental, and vision insurance
• Paid time off
• A 401k plan with a generous match
• A chance to make a real difference in the Imperial Valley community
  
  

Preference will be given to candidates who are local to Imperial, California, but remote candidates living in California will also be considered.

We are an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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Community Health Plan of Imperial Valley (CHPIV) is Imperial County's Medi-Cal managed care plan. We are a locally managed public health care plan committed to working with members, providers, and the residents of Imperial County.

As we continue to build something great, we are looking for a Compliance Manager to lead the compliance program at CHPIV.

Our next team member will do the following:

• Oversees regulatory compliance activities including regulatory audits and regulatory reports
• Supervise the Compliance Advisor and provide mentorship and guidance
• Develop and deliver comprehensive compliance training programs for employees, management, and relevant stakeholders, promoting a culture of compliance awareness and ethical conduct throughout the organization.
• Develop and deliver compliance training programs for employees, management, and relevant stakeholders. Promote a culture of compliance awareness and ethical conduct throughout the organization.
• Work closely with the Senior Director of Compliance to develop strategies for effectively managing the Regulatory Compliance team
• Provide strategic guidance to internal business units and delegates to identify gaps, develop and implement corrective action plans and facilitate monitoring activities to ensure compliance with regulatory requirements.
• Develop, maintain, and monitor Compliance & Policy Committee (CPC) Charter, Compliance Program and key performance indicators. Responsible for the development of Board/committee write-ups to be presented at Compliance Committees and other committees as needed
• Take a leading role in managing external state and federal regulatory audits, ensuring compliance and addressing any issues that arise. Develop and implement comprehensive regulatory audit readiness programs, such as conducting mock audits to proactively identify and address potential compliance gaps. Coordinate audit preparation activities, facilitate audit responses, and ensure that all regulatory requirements are met
• Monitor and evaluate the effectiveness of the Compliance Program, making improvements as necessary to ensure optimal performance and regulatory adherence
• Prepare and present regular reports on compliance activities, risks, and outcomes to the senior leadership team, providing insights and recommendations for continuous improvement
• Liaise with external regulatory bodies and industry groups to stay current with compliance trends, changes in legislation, and best practices, and integrate this knowledge into the organization's compliance framework
• Lead the development and implementation of risk assessment methodologies to identify, analyze, and mitigate potential compliance risks
  
  

You may be right for this job if you have the following:

• Bachelor’s degree in public health or health care management from an accredited college or university; or equivalent education/experience in related area
• 5+ years of experience working in the compliance function in a Medi-Cal managed care setting
• Knowledge of Medi-Cal Managed Care principles
• Working knowledge of DHCS and Knox-Keene requirements, as well as highly developed analytical and critical thinking skills, to serve as a resource to internal business units and delegates
  
  

Our commitment to you:

• A competitive salary of $110,000-$125,000/ year
• Health, dental, and vision insurance
• Paid time off
• A 401k plan with a generous match
• A chance to make a real difference in the Imperial Valley community
  
  

Preference will be given to candidates who are local to Imperial, California, but remote candidates living in California will also be considered.

We are an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Powered by JazzHR

ULEBv7lhC3