Compliance Manager of Risk Management & Oversight - Medicare Advantage

at  UCLA Health

Description
As the Compliance Manager, Risk Management & Oversight, you will play a key role in developing and managing processes that maintain essential elements of our compliance efforts within the Medicare Advantage program.
In this role, you’ll oversee policy and procedure management, training, regulatory distribution, risk management, and incident management. Leveraging your deep knowledge of CMS Medicare Advantage and DMHC insurance regulations, you’ll implement industry-leading practices that meet and exceed regulatory requirements. Your expertise in managing relationships and collaborating across various business operations will be essential in driving compliance success.

Key responsibilities include:

• Develop and manage compliance program processes, including policy management, training, regulatory submissions, and risk management.
• Ensure adherence to CMS Medicare Advantage and DMHC insurance regulations through the application of best practices.
• Collaborate effectively with business partners to support compliance objectives.
• Lead a team of direct reports, fostering a high-performance culture that aligns with departmental and organizational goals.

Salary Range: $112,900 - $256,900/annually
Qualifications

We’re seeking a results-oriented, experienced compliance leader with:

• A Bachelor’s degree in Business Administration, Healthcare, or a related field required.
• Five or more years of experience in a Medicare Advantage and Part D Managed Care compliance role is required.
• Three or more years of leadership experience building and leading high-performing teams required.
• Strong knowledge of CMS regulations, expectations, and best practices.
• CHC certification is highly desired.
• Experience interacting with regulatory agencies and auditors.

• Develop and manage compliance program processes, including policy management, training, regulatory submissions, and risk management.
• Ensure adherence to CMS Medicare Advantage and DMHC insurance regulations through the application of best practices.
• Collaborate effectively with business partners to support compliance objectives.
• Lead a team of direct reports, fostering a high-performance culture that aligns with departmental and organizational goals