Advisor Regulatory Operations Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11888 Salary Range: $110,279.00 (Min.) - $146,120.00 (Mid.) - $181,961.00 (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 Advisor for Regulatory Operations plays a pivotal role in shaping and executing compliance and regulatory strategies across L.A. Care. This position involves leading cross-functional initiatives to ensure alignment with federal, state, and industry-specific regulatory requirements, driving process optimization, and enhancing the organization’s compliance framework. The Regulatory Operations Advisor partners with internal stakeholders to provide expert guidance on implementing regulatory changes, executing the compliance workplan, and fostering a culture of 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 expert advice to various teams, including program and product development, marketing, and customer service, on various relevant topics. Duties Develops reports, analyzes data, and provides presentation on status of areas of responsibilities on an as needed basis in support of department operations. Partners with the management to communicate compliance and operational priorities and provide feedback or follow-ups to key stakeholders. Acts as the point of contact for key strategic initiatives. Provides expert advice to various business units on relevant topics within the organizational standards, national and state-wide compliance. 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. Collaborate closely with senior management to identify, assess, and address compliance risks, ensuring solutions are aligned with organizational goals and regulatory requirements. Facilitate cross-functional discussions to develop proactive strategies and implement sustainable controls that mitigate risks while driving operational efficiency. Responsible for advising on the regulatory implications of emerging business opportunities, ensuring that strategic initiatives are aligned with evolving industry and regulatory standards. Oversees the development and execution of training programs to elevate regulatory awareness and competence at all organizational levels. Collaborates with cross-functional departments to ensure compliance programs are seamlessly integrated with organizational priorities and operational goals. Provides expert guidance on regulatory matters, addressing inquiries and offering solutions for both immediate and long-term compliance challenges. Responsible for designing and implementing data analytics tools and dashboards to track performance, monitor compliance trends, and inform strategic decision-making.Duties Continued Works closely with senior leadership to anticipate regulatory shifts, advocate for necessary changes, and position the organization as a leader in compliance excellence. Influences decision-making and deliver measurable outcomes by a blend of strategic foresight, operational acumen, and exceptional communication. Serve as a key advisor to executive leadership, translating regulatory complexities into actionable strategies that enhance organizational compliance and foster a culture of accountability and integrity . Perform other duties as assigned . Education Required Bachelor's DegreeEducation Preferred Master's DegreeExperience At least 5 years of experience designing, enhancing, and implementing comprehensive compliance programs and managed care operations for Medicare, Medicaid, and commercial health plans. Experienced in generating executive-level compliance reports and leveraging data-driven insights to inform strategic decisions and drive continuous improvement efforts. Experienced with Governance, Risk, and Compliance (GRC) tools, project management platforms, and data analytics tools, including SharePoint, Smartsheet, Tableau, and Alteryx/SQL Experienced in navigating complex regulatory landscapes, engaging with regulators, auditors, and external stakeholders to promote transparency and achieve compliance success. Experienced in managing high-performing teams with a strong emphasis on coaching, mentoring, and professional development. Skills Required: Deep understanding of the regulatory landscape, operational workflows, and strategic principles, combined with strong leadership and analytical capabilities. Demonstrated ability to create scalable compliance strategies that effectively mitigate risks, optimize processes, and ensure adherence to evolving regulatory requirements across complex healthcare landscapes. Proven ability to foster a culture of accountability and innovation, ensuring teams adopt leading industry practices, leverage advanced tools and technology, and align with organizational compliance objectives. Exceptional skills in identifying and addressing regulatory and compliance risks. Demonstrated knowledge and ability in developing actionable corrective plans and implementing monitoring systems to track issues from detection through remediation. Proven ability to remain agile in a fast-paced environment, addressing emerging risks and adapting strategies to meet evolving business and regulatory needs. Exceptional verbal and written communication skills, with the ability to present complex regulatory concepts clearly and effectively to diverse audiences, including executives, regulators, and board members. Proven ability to partner with legal, finance, operations, and IT teams to align compliance initiatives with broader organizational strategies. Licenses/Certifications Required Licenses/Certifications Preferred Certified HealthCare Compliance (CHC)Project Management Professional (PMP)Required Training Physical Requirements LightAdditional Information Additional Required & Preferred Skills:Strong proficiency in data analysis, compliance tracking, and reporting to executive leadership. Exceptional skills in preparing detailed reports, dashboards, and presentations to communicate compliance metrics and trends. Familiarity with compliance management software, analytics tools, and dashboard creation is preferred. Proficient in utilizing compliance tools to manage projects, perform analytics, and streamline operational processes. Preferred: Comprehensive understanding of state and federal regulations, including Centers for Medicare and Medicaid Services (CMS) guidelines, Health Insurance Portability and Accountability Act (HIPAA), Affordable Care Act (ACA), Knox-Keene Act, and other applicable laws. Experience in applying regulatory requirements to operational processes and designing scalable solutions to ensure ongoing adherence. 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
Volunteer Time Off (VTO)
