Manager, Regulatory Affairs

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Job description

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 in five health plans, 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 Manager, Regulatory Affairs serves as a senior leader within the Compliance Department. The Manager will manage the Regulatory Affairs unit, including managing the relationships with state and federal regulatory agencies and leading communication between L.A. Care business units regarding ad-hoc and routine inquiries or issues regarding member care, regulatory guidance analysis, and plan performance. In addition, the Manager will leverage new opportunities to interface with regulatory agencies to promote visibility of the Plan and member priorities and maintain a system to track and trend regulatory priorities. The Manager will develop regulatory reports, agendas, minutes and communications to the Internal Compliance Committee and the Compliance and Quality Committee of the Board of Governors. The Manager will prepare executive summaries and reports, develop and conduct training activities for subordinates, peers and L.A. Care business units and lead or participate in interdisciplinary/cross-functional teams. Although the Manager's primary responsibility is management of the Regulatory Affairs unit, the Manager will also advise and support the Directors and Chief Compliance Officer on other duties as assigned to support the mission and responsibilities of the Compliance Department and to support the mission and business operations of L.A. Care Health Plan.

Duties

Manage day to day operations and activities of the team, including the hiring and supervision of staff and evaluation of staff performance. Provide direction to staff on projects, resolve and respond to questions and issues raised by senior management, staff, providers and third-parties. Continually assess technical and other job-related skills and knowledge of staff, and deploy needed training. Develop, implement and monitor ongoing employee engagement plans.

Draft and timely revise policies and procedures, desk-top manuals and other guidance for effective and efficient administration of team functions. Lead special projects as needed.

Serve on, lead and facilitate in cross-functional workgroups and meetings, including preparing and supporting presentations, reports, data and recommendations.

Ensures that ad-hoc and routine inquiries or issues regarding member care, regulatory guidance analysis, and plan performance are addressed promptly. In addition, the Manager will leverage new opportunities to interface with regulatory agencies to promote visibility of the Plan and member priorities and maintain a system to track and trend regulatory priorities

Ensure compliance with all organizational, contractual, regulatory, and accreditation standards applicable to the functions under Manager.

Perform other duties as assigned.

Education Required

Bachelor's Degree

In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Experience

Required:

At least 5-7 years of health care or related experience designing, implementing compliance programs, policies and practices: and/or managed health plan/managed care business operations.

At least 3-4 years supervisory/management or equivalent experience.

Experience with implementing or supporting the implementation of managed Medicare, Medicaid or commercial regulations.

Skills

Required:

Strong organizational and planning skills, including flexibility to handle multiple assignments, changing priorities, and compressed deadlines.

Proficient in MS Office, including with Word and Excel.

Excellent interpersonal, verbal and written communication skills, including to senior management.

Functions well in team and matrixed work environment, collaborating effectively with team members and other departments.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Additional Information

Regulatory Agency Management: Manage account management relationships with regulators; this includes collaborating with all levels of organizational management, business units and our Delegates on timely, accurate, and complete submissions. This includes self-disclosures of non-compliance issues to the regulators. The Manager also oversees and maintains a centralized and streamlined information sharing process in order to track and trend communications to identify risk areas and regulatory priorities.

Regulatory Audits and Monitoring: Manage regulatory audits; this includes collaborating with all levels of organizational management, business units, and our Delegates on establishing processes that meet compliance. The Manager oversees and maintains a centralized and streamlined monitoring program to track status of enterprise-wide compliance for high risk and high member impact related measures.

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)

At L.A. Care, we value our team members' safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.

Nearest Major Market: Los Angeles

Job Segment: Medical, Medicare, Medicaid, Healthcare