Senior Manager, Compliance Delegation Oversight Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11890 Salary Range: $117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (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 Senior Manager, Compliance Delegation Oversight is a solutions-oriented, strategic thinker with expertise in change management, process improvement, and developing compliance strategies that enhance daily operations. The Senior Manager is responsible for overseeing key Compliance Delegation Oversight functions, including but not limited to, a Governance/Oversight team and Delegate/FDR communication teams. The Senior Manager will work closely with cross-functional units/ departments involved in oversight activities. to mature delegation oversight practices. This position is responsible for identifying compliance and performance risks, enhancing the monitoring and auditing processes, and establishing mitigation strategies to ensure compliance with regulatory and accrediting agencies. As a key partner to the cross-functional departments, the Senior Manager will lead efforts to identify trends, close gaps, and drive continuous process improvement. They will implement industry-leading practices while leveraging change management techniques to ensure smooth adoption and operationalization. Additionally, the Senior Manager will apply a strong technology acumen to develop scalable, repeatable processes that drive operational efficiency. Serving as the central point of contact for delegate compliance issues, they will manage, escalate, and resolve performance issues, while collaborating with the Delegation Oversight Committee, Vendor Risk Management Committee, and Senior leadership. The Senior Manager will also support other delegate and regulatory operations/compliance activities that may involve delegates/FDRs. This position manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports. Duties Strategic Leadership, Team Management, and Professional Development: Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities. Provide strategic direction and leadership to the team, ensuring alignment with organizational goals and objectives. Manage staff, including, but not limited to monitoring of day-to-day activities of staff, monitoring of staff performance, 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, among others. Foster a culture of continuous learning and growth by mentoring, coaching, and developing staff on best practices, compliance tools, and emerging industry trends. Ensure team members have the resources and support necessary to achieve professional development goals and enhance their contributions to organizational success. Operational Excellence and Process Enhancement: Oversee day-to-day operations, driving operational efficiency and effectiveness to meet and exceed performance targets. Draft and refine comprehensive process maps, policies, procedures, and guidance documents, optimizing team functions for maximum productivity. Champion process improvement initiatives, leveraging best practices to streamline workflows and enhance overall standardized and repeatable operational outcomes . Change Management and Program Development: Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. Lead change management efforts for the implementation of new programs, systems, or policies across the team, ensuring that changes are adopted efficiently and effectively. Design and implement training and communication strategies to support staff and stakeholders during transitions . Cross-Functional Collaboration and Leadership: Play a pivotal role/lead in inter-departmental collaborations and workgroups/committees, leading and facilitating discussions to achieve cross-functional alignment. Prepare, support, and deliver engaging presentations, reports, and data-driven recommendations in various settings. Serve as a key liaison between departments, fostering seamless communication and collaboration for successful project execution. Duties Continued Regulatory Expertise and Compliance Oversight: Stay at the forefront of regulatory changes and industry leading practices, analyzing and being a change agent to drive implementation of new and revised applicable regulations, laws, and sub-regulatory guidance from state and federal agencies. Risk Management, Vendor Oversight, and Performance Monitoring: Lead risk management efforts by overseeing compliance and operational risks related to vendors, delegates, and third-party service providers. Ensure alignment with regulatory and organizational standards while fostering strong vendor relationships. Oversee performance monitoring activities, including audits, to ensure continuous improvement and compliance. Collaborate with cross-functional teams to address any identified issues and implement necessary corrective actions. Technology Integration and Data-Driven Decision Making: Leverage data analytics and emerging technologies to optimize processes and enhance decision-making capabilities. Drive the adoption of technology solutions to automate compliance tracking, reporting, and operational processes, ensuring scalability and repeatability in execution. Compliance and Quality Assurance: Ensure adherence to organizational, contractual, regulatory, and accreditation standards relevant to the team's functions. Implement and maintain robust quality assurance processes that consistently meet and exceed compliance requirements, ensuring all operations align with the latest regulatory guidelines and best practices. Perform other duties as assigned. Education Required Bachelor's Degree in Healthcare Management, Public Health, Business, Health Administration or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.Education Preferred Master's Degree in Healthcare Management, Public Health, Business, Health Administration or Related FieldExperience Required: At least 6 years of healthcare experience in designing, redesigning, and implementing compliance programs, policies, and managed care operations, including Medicare, Medicaid, and commercial health plans. Proven ability to develop scalable compliance strategies that mitigate risks, optimize processes, and ensure regulatory adherence across complex healthcare environments. At least 4 years of experience leading, supervising and/or managing teams and staff, with a strong focus on coaching and mentoring to ensure adoption of leading practices in industry tools, technology, and compliance approaches. Proven experience in change management and operational process improvement, focused on driving sustainable, repeatable processes through well-defined process maps, robust governance structures, and comprehensive supporting documentation to ensure long-term implementation success. Proven experience and ability in identifying and managing regulatory/compliance risks and issues, developing corrective action plans, and implementing compliance monitoring systems to track issues through remediation. Skilled in generating regular compliance reports for executive leadership and using data-driven insights to drive continuous improvements. Experience working with regulatory agencies and cross-functional teams, including legal, finance, operations, and IT, to align compliance initiatives (e.g., implement new/updated regulations) with broader organizational goals. Experience leveraging technology to enhance compliance tracking, reporting, and operational processes. Proven experience with Governance, Risk, and Compliance (GRC) tools and collaborative tools to manage projects, perform analytics, and scale processes. Extensive experience in creating executive-level reports and analyzing data using Microsoft applications such as Microsoft office Suite, SharePoint, Smartsheet, Tableau, Alteryx/SQL, and/or other applicable tools. Preferred: Extensive experience in healthcare consulting or relevant advisory experience, with a track record of delivering scalable and innovative solutions in dynamic environments and recognized as a strong collaborative partner who works effectively across teams and functions. Skills Required: Strong expertise in developing, redesigning, and implementing compliance programs, policies, and practices within healthcare organizations. Demonstrated ability to engage with regulators, auditors, and external stakeholders to ensure compliance transparency and ongoing success. Proven ability to drive team performance, foster professional development, and align staff with organizational objectives. Skilled in integrating technology solutions into compliance programs to improve overall effectiveness and scalability. Proven ability to interpret and implement complex regulations, ensuring organizational adherence and mitigating compliance risks. Advanced Knowledge of regulatory compliance and regulations across multiple lines, including Centers for Medicare and Medicaid Services (CMS), Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), and other governing bodies. Licenses/Certifications Required Licenses/Certifications Preferred Certified HealthCare Compliance (CHC)Certified in Healthcare Compliance Fellow (CHC-F)Certified Compliance & Ethics Professional (CCEP)Project Management Professional (PMP)Lean Six SigmaRequired Training Physical Requirements LightAdditional Information Additional Required Skills:Strong background in managed health plan/managed care business operations, including Medicare, Medicaid, and commercial regulations. Demonstrated ability to stay organized, manage multiple projects simultaneously, and utilize project management tools to ensure teams are aligned, deadlines are met, and goals are achieved efficiently. Proven ability to coach, mentor, and train teams, fostering skill development, growth, and high performance. Skilled in leading change management initiatives that drive operational improvements, sustainability, and process efficiencies. Advanced ability to design and implement process maps, policies, procedures, and tools that improve operational efficiency and scalability. Expertise in using Governance, Risk and Compliance (GRC) tools for risk management, stakeholder engagement, reporting, and process scaling. Strong focus on leveraging data and technology to optimize processes, analyze performance, and drive decision-making. Proficient in collaborative and reporting tools such as SharePoint, Smartsheet, Tableau, Alteryx, and SQL for data analysis, reporting, and process optimization. Adept at presenting complex data insights clearly and concisely to support informed decision-making at the leadership level. Skilled in using advanced Microsoft tools for data visualization, analysis, and reporting to drive strategic initiatives. Adept at designing scalable processes that drive efficiency and long-term success. A self-starter who thrives in fast-paced, ever-changing environments, known for innovation and adaptability. 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)
