Advisor Enterprise Compliance

Purpose

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.

Job Summary

The Advisor Enterprise Compliance supports the implementation and maintenance of key elements of the organization’s compliance framework. This position is responsible for overseeing the development and review of organizational policies and procedures, administering the governance, risk, and compliance (GRC) system, and supporting compliance reporting activities.

Duties

• Policy and Procedure Management: Draft, review, and maintain organizational policies and procedures in alignment with regulatory and contractual requirements. Manage the policy and procedure module within the GRC system, ensuring documents are current and accessible. Support operational execution of policy lifecycle processes and related documentation.

• GRC System Administration: Administer the enterprise GRC platform, ensuring accurate configuration, timely updates, and effective user support. Monitor system performance and coordinate enhancements or troubleshooting as needed.

• Exclusion Monitoring: Conduct and document exclusion monitoring activities in alignment with regulatory requirements. Prepare reports on monitoring outcomes and escalate issues as appropriate.

• Ethics Hotline and Civil Rights Mailbox: Oversee intake and tracking of ethics and civil rights concerns submitted through hotline and mailbox channels. Coordinate documentation, triage, and follow-up processes to ensure timely resolution. Maintain accurate records and prepare summary reporting.

• Compliance Reporting: Support the preparation of compliance reports and dashboards for key stakeholders. Provide timely and accurate data for reporting on compliance program operations and outcomes.

Education and Experience

• Required: Bachelor's Degree in Healthcare Administration or Related Field. At least 5 years of experience in designing, implementing, or monitoring regulatory requirements, policies, or practices in a healthcare or related setting.

• Preferred: Master's Degree in Healthcare Administration or Related Field. Experience with governance, risk, and compliance (GRC) systems. Experience in data analysis, understanding payment rates, and managing healthcare costs.

Skills

• Strong organizational and planning skills. Ability to handle multiple assignments, changing priorities, and competing deadlines. Solid understanding of regulatory compliance guidelines and policies. Strong verbal, written communication, and presentation skills. Strong analytical and problem-solving skills. Ability to work collaboratively with cross-functional teams. Ability to clearly and effectively convey information. Ability to analyze complex situations, data, and information to identify issues and develop effective solutions. Ability in building and maintaining strong, trusting relationships with stakeholders. Ability to adjust to changing trends, industries, and client needs. Possess extensive, specialized knowledge in their field.

Physical Requirements

Additional 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).