Manager, Compliance Monitoring Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11889 Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (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 Manager, Compliance Monitoring serves as a leader within the Corporate Compliance Monitoring Department. This position provides leadership and oversight of compliance monitoring, focusing on the effective implementation of corrective action plans (CAPs) and the mitigation of compliance risks throughout the organization. A key component of the role is to enhance monitoring processes, ensuring that federal, state, contractual, accreditation, and internal Plan requirements are met consistently and accurately. The primary responsibility of this role is to oversee the comprehensive monitoring of compliance activities, with particular attention to corrective action plans arising from regulatory or audit findings. By ensuring CAPs are effectively tracked, implemented, and mitigated, the role plays a crucial part in the resolution of non-compliance issues. The Manager collaborates with cross- functional business units essential in optimizing the success and sustainability of corrective actions, thereby enhancing the organization’s compliance posture. The Manager advises and supports the senior management on other duties as assigned to support the mission and responsibilities of the Corporate Compliance Monitoring Department, and to support the mission and business operations of L.A. Care Health Plan. The Manager manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports. Duties Responsible for developing and implementing a comprehensive monitoring program to track and assess the effectiveness of corrective actions addressing identified deficiencies. Develops policies, procedures, and tools to ensure systematic and consistent monitoring throughout the organization. Maintains a centralized tracking system to document deficiencies, assign ownership, and establish clear timelines for resolution. Responsible for developing and maintaining key performance indicators (KPIs) and monitoring systems to proactively detect compliance risks. Develops regulatory reports, summaries, and agendas to communicate to the Internal Compliance Committee (ICC) and the Compliance and Quality Committee of the Board of Governors, as needed. Prepares executive summaries and monitoring reports to share with L.A. Care business units. Responsible for running and maintaining regular reports that includes dashboards, charts, and graphs. Present reports to senior leadership and relevant committees. Collaborate with key internal and external stakeholders and with cross-functional units/ departments to ensure cohesive monitoring of compliance across both delegated and non-delegated functions. Facilitates the preparation for internal and external regulatory audits, providing detailed data analyses of audit findings, addressing deficiencies, and ensuring corrective actions are tracked and completed effectively. Manage staff, including, but not limited to hiring staff, monitoring of day-to-day activities of staff, monitoring of staff performance, performance reviews, mentoring, training, and cross training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, disciplinary matters for direct reports, among others. Duties Continued Lead, guide and mentor teams in the collection, analysis, and interpretation of compliance data. Ensure that staff are effectively trained, and cross-trained, while being empowered to suggest system and process enhancements. Develop and timely revise policies and procedures, desktop manuals and other guidance for effective and efficient administration of team functions. Lead special projects as needed. Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities. Staying aligned with regulatory requirements and industry standards, the Manager of Internal Monitoring will adjust practices as needed to reflect changing expectations. Escalates to appropriate staff and management unresolved or recurring deficiencies that pose significant risks, prioritizing resource allocation, and leveraging technology to enhance monitoring capabilities. Perform other duties as assigned. Education Required Bachelor's Degree in Related FieldIn lieu of degree, equivalent education and/or experience may be considered.Education Preferred Master's Degree in Business Administration or Related FieldExperience Required: At least 5years of progressive experience in internal or external auditing/monitoring, regulatory compliance, or related fields. At least 3 years of leading, supervising or managing staff experience. Demonstrated experience leading and managing audits, preferably in a regulated industry such as banking, finance, healthcare, pharmaceuticals, or manufacturing. Experience with implementing or supporting the implementation of managed Medicare, Medicaid or commercial regulations. Equivalency: Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement. Skills Required: In-depth understanding of relevant regulatory requirements, standards, and frameworks applicable to the managed health care industry. Familiarity with regulatory bodies such as the Centers for Medicare and Medicaid Services (CMS), the Department of Managed Healthcare (DMHC), and the Department of Health Care Services (DHCS). Strong organizational and planning skills, including flexibility to handle multiple assignments, changing priorities, and compressed deadlines. Proficient in MS Office, including with Word, Excel and PowerPoint Excellent interpersonal, verbal and written communication skills. Strong analytical and problem-solving skills, with the ability to analyze data, evaluate controls, and identify trends, patterns, and anomalies. Proficiency in using data analytics tools and techniques to enhance audit effectiveness and efficiency. Proficiency in project management methodologies, tools, and techniques, with experience in planning, executing, and monitoring audit projects within established timelines and budgets. Ability to drive results and balance management of organizational risk and meeting goals of the business. Preferred: Deep understanding of the healthcare industry, regulatory model, products, services, and regulatory agencies. Familiarity with industry-specific regulations, challenges, and emerging trends is beneficial. Licenses/Certifications Required Licenses/Certifications Preferred Certified Internal Auditor (CIA)Certified Regulatory Compliance Manager (CRCM)Certified HealthCare Compliance (CHC)Required Training Physical Requirements LightAdditional Information 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)
