Senior Manager, Compliance Delegation Oversight Affairs

L.A. Care Health Plan•Los Angeles, CA

About The Position

The Senior Manager, Compliance Delegation Oversight Affairs is responsible for managing and strengthening the Compliance Department’s communication and engagement with delegated entities and their compliance teams. This position ensures L.A. Care maintains an initiative-taking, transparent, and defensible oversight posture consistent with regulatory expectations. The Senior Manager leads the communications arm of the Compliance Delegation Oversight program, overseeing activities that include, but not limited to, compliance-related correspondence, distribution of regulatory guidance, issuance and tracking of formal Notices of Non-Compliance (NONCs), Corrective Action Plan (CAP) management, and audit and monitoring communication support. The Senior Manager will manage a team that serves as L.A. Care’s Compliance point of contact for assigned delegates, facilitating consistent, compliance-focused communication to prevent, detect, and mitigate risks across the delegated network. This position is responsible for the Compliance’s communications to delegate-related regulatory matters, ensuring issues are identified, assessed, and addressed through structured communication and oversight processes. The position works with cross-functional departments to promote alignment, timely follow-up, and clear documentation of oversight activities. This position manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports. Responsible for driving performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care. Oversees the development, implementation, administration, and maintenance of the department's programs, policies, and procedures. Responsible for driving management and performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care. Collaborate closely with executive/ senior management to establish goals that align with the company’s mission and vision.

Requirements

Bachelor's Degree in Healthcare Administration or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.
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.
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 identifying and managing regulatory and compliance risks, issues, developing corrective action plans, and implementing compliance oversight systems to track issues through remediation.
Experience working with regulatory agencies and cross-functional teams to align compliance initiatives 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.
Strong ability to align delegation practices with organizational goals and long-term vision
Skilled in generating regular compliance reports for executive leadership and using data-driven insights to drive continuous improvements.
Proven ability to develop scalable compliance strategies that mitigate risks, optimize processes, and ensure regulatory adherence across complex healthcare environments.
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.
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.
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.
An initiative-taker who thrives in fast-paced, ever-changing environments, known for innovation and adaptability.
Strong people skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members.
Strong attention to detail and ability to manage multiple priorities and tight deadlines.
Ability and exceptional knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation.
Demonstrated ability to make informed decisions.
Strong verbal, written communication, and presentation skills.
Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals.
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Nice To Haves

Master's Degree in Healthcare Administration or Related Field
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.
Certified HealthCare Compliance (CHC)
Certified in Healthcare Compliance Fellow (CHC-F)
Certified Compliance & Ethics Professional (CCEP)
Project Management Professional (PMP)
Lean Six Sigma Green Belt
Lean Six Sigma Black Belt

Responsibilities

Provide strategic leadership to the Compliance Delegation Oversight Affairs team as the communication arm of the program, ensuring delegate-facing compliance engagement and correspondence align with regulatory expectations and oversight priorities
Plan and implement 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 and the day-to-day activities in the department. Participates in the department budgeting process. Responsible for scheduling, training, performance, corrective actions, mentoring, developing of the team(s). Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals. Mentors and develops staff, building technical and critical thinking skills across the team.
Responsible for overseeing and managing the budgets of their respective departments.
Oversee delegate-facing compliance engagement and documentation management. Develop and maintain standardized tools and workflows for issuing and tracking key communications such as Notices of Non-Compliance (NONCs), Corrective Action Plans (CAPs), and other regulatory correspondence.
Drive active delegate engagement through routine compliance touchpoints, using tools and staff interactions to spot trends, emerging risks, and communication gaps. Ensure insights from these engagements feed back into monitoring and oversight activities.
Responsible for Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
Ensure timely, accurate, and defensible documentation of oversight communications. Champion process improvements that strengthen transparency, accountability, and coordination across the delegated network.
Manage the rollout of new compliance communication protocols, regulatory updates, and oversight frameworks impacting delegated entities. Lead change management efforts that enhance coordination between L.A. Care Compliance and delegate Compliance teams, ensuring consistent understanding and adoption of regulatory requirements.
Manage complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.
Plan and implement systems and procedures to maximize operating efficiency and achieve strategic priorities. Design and implement training, outreach, and communication strategies to build awareness and readiness across both internal and external stakeholders. Serve as a key facilitator in implementing new regulatory expectations and process improvements affecting oversight communication and audit readiness.
Implements and provides guidance to the departmental and organizational processes and policies and works with senior and/ or executive management to define, prioritize, and develop projects and programs.
Lead inter-departmental collaborations, committees, 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 execution of initiatives.
Stay at the forefront of regulatory changes and industry leading practices, analyzing and being a change agent to drive L.A. Care and Delegate’s implementation of new and revised applicable regulations, laws, and sub-regulatory guidance from state and federal agencies.Duties ContinuedOversee all regulatory and/or compliance communications to delegated entities, ensuring timely distribution, coordination, and documentation across Compliance Delegation Oversight units. Partner with internal teams to track, escalate, and close issues identified through monitoring, audits, or delegate self-reporting. Serve as the central coordination point for all regulatory related communications and delegate oversight correspondence, maintaining consistency, traceability, and defensibility. Ensure organized, auditable records and timely follow-up with internal leadership, regulators, and delegate compliance teams to support transparency and accountability across the oversight program.
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.
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
Performs other duties as assigned