Director, Regulatory Compliance
4 weeks ago
The Director, Regulatory Compliance (Medical Group) is responsible for implementing and maintaining a comprehensive provider compliance program. The position will be responsible for developing and leading training, policy development, monitoring auditing, reporting and enforcement efforts necessary to effectuate an effective provider compliance program. Additionally, the position will assist in the assessment of a variety of complex compliance risk areas within the Health System to help develop the annual healthcare compliance work plan. The Director, Regulatory Compliance (Medical Group) will be responsible for recruiting, screening, hiring, training and directly supervising all assigned subordinate staff for the provider compliance program. The position also will be responsible for collaborating with Keck Medicine of USC ("Keck Medicine") ambulatory clinics, providers and coding staff regarding healthcare compliance risks, controls and new developments in laws and regulations, as well as to support compliance with policies and regulations relating to clinical documentation.
Essential Duties:
Manages Keck Medicine's provider healthcare compliance program, systems, processes, and policies. Ensures program fully addresses all elements of an effective compliance program and serves to promote compliance by faculty and staff with the Keck Medicine code of conduct, standards, and policies. Develops short and long-term strategies for provider healthcare compliance initiatives. Plans and develops program objectives. Assists with designing, implementing, maintaining, and communicating an effective provider healthcare compliance program. Coordinates closely with applicable senior management and administrators regarding provider healthcare compliance efforts. Organizes and manages provider compliance liaison committee.Develops and leads education and communication plan for management, faculty, employees, and staff that promotes knowledge of the provider compliance program and the guidance and resources available through the compliance program. Interacts with providers and coding staff to facilitate modifications to clinical documentation to improve the overall quality and completeness of clinical documentation. Reviews the medical record documentation and identifies and conveys deficiencies to providers.Collaborates in a proactive manner, in close collaboration with the Chief Healthcare Compliance and Privacy Officer, with Keck Medicine ambulatory clinics regarding healthcare compliance risks, controls and new developments in healthcare-related compliance laws and regulations. Provides subject matter expertise and recommends responses and/or procedures on compliance related matters such as laws, regulations, and program guidance for Medicare, Medi-Cal and other regulated payers. Additional subject matter expertise should include, but is not limited to, clinical research billing, lab billing, and Quality Payments Programs.Recruits, screens, hires, trains, and directly supervises all assigned subordinate staff. Evaluates employee performance and provides guidance and feedback, including appropriate discipline, as required.Conducts regular assessment of a variety of complex compliance risk-areas within Keck Medicine to develop the provider compliance work plan. Independently performs scheduled audits required by the work plan, as well as unplanned investigations. Determines appropriate corrective action and ensures that corrective action is taken. Monitors and responds to certain regulatory requests. Represents the healthcare compliance team on various committees as requested.Creates periodic comprehensive provider compliance program reports for both the Health System Board and entity-level boards, management and appropriate individuals and departments, as needed.Conducts independent research in areas pertaining to billing and regulatory compliance (e.g., Medicare, Medicaid and/or other legal authorities). Maintains currency with Keck Medicine policies, applicable state, federal and administrative laws, regulations, and trends impacting the provider compliance program. Develops necessary education and training for management and staff regarding payer regulatory requirements and other compliance matters.Manages audits conducted by vendors and payers. Provides regular status reports to senior management. Assists with coordination of responses to and resolutions of external investigations and audits by government agencies and payers.Conducts investigations of reports of compliance violations, wrongdoing, etc., as requested. Makes recommendations for corrective action, as appropriate. Assists with compliance enforcement and discipline.Performs other related duties as assigned or requested. The Health System reserves the right to add or change duties at any time.Required Qualifications:Req Bachelor's Degree In related fieldReq 8 years Healthcare compliance, medical coding, auditing healthcare claims, utilization reviews and/or other related experience.Req Demonstrated experience with implementing healthcare compliance program.Req Demonstrated understanding of healthcare operations.Req Strong interpersonal skills and ability to deal effectively with diverse skill sets and personalities.Req Strong data analytic and reporting skills.Req Excellent oral, written and presentation skills.Req In-depth knowledge in the areas of Medicare, Medicaid, and commercial insurance billing regulations.Req Knowledge of healthcare licensing/ accreditation standards is required as is knowledge of other state and federal laws and regulations which affect corporate compliance operations.Req Credentialed as a Certified Procedural Coder. Directly related professional and supervisorial experience in healthcare compliance, including billing compliance. Knowledge of applicable federal, state and local laws, regulations and policies. Strong interpersonal skills to deal effectively and tactfully with people at all levels of management. Demonstrated ability to communicate effectively, both verbally and in writing.Preferred Qualifications:Pref Master's degreeCombined experience/education may act as substitute for minimum education requirement.Required Licenses/Certifications: Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
The annual base salary range for this position is 191, $315, When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
-
Senior Director, Regulatory Compliance
3 months ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $149, Min.) - $201, Mid.) - $254, 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 in five health plans, we make...
-
Senior Director, Regulatory Compliance
3 months ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $149,502.00 (Min.) - $201,827.00 (Mid.) - $254,152.00 (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...
-
Los Angeles, California, United States CPS Inc Full timeJob SummaryCPS Inc. is seeking a highly experienced and skilled Director of Regulatory Affairs to lead our regulatory strategy and ensure compliance with domestic and international regulations.Key ResponsibilitiesRegulatory Leadership: Develop and implement regulatory strategies to ensure compliance with US and international regulations, including FDA, USDA,...
-
Compliance Director
3 days ago
Los Angeles, California, United States Wayoh Full timeJob SummaryWe are seeking a highly experienced Compliance Director to join our team at Wayoh. As a key member of our organization, you will be responsible for ensuring the company's compliance with regulatory requirements, client guidelines, and internal policies and procedures.Key ResponsibilitiesRegulatory Compliance: Monitor and interpret changes in...
-
Head of Regulatory Compliance
4 days ago
Los Angeles, California, United States CPS Inc Full timeDirector of Regulatory Affairs - West CoastDirector of Regulatory Affairs – West CoastThe Director of Regulatory Affairs at CPS, Inc. will act as the principal authority in Scientific & Regulatory Affairs, managing all aspects of U.S. and international regulations (including EU, CAN, AUS, and others), as well as overseeing third-party certifications for...
-
Head of Regulatory Compliance
3 days ago
Los Angeles, California, United States CPS Inc Full timeDirector of Regulatory Affairs - West CoastDirector of Regulatory Affairs – West CoastThe Director of Regulatory Affairs at CPS, Inc. will act as the foremost authority in Scientific & Regulatory Affairs, managing all aspects of U.S. and international regulations (including EU, CAN, AUS, and others), as well as overseeing third-party certifications for our...
-
Head of Regulatory Compliance
4 days ago
Los Angeles, California, United States CPS Inc Full timeSenior Director of Regulatory AffairsPosition Overview:The Senior Director of Regulatory Affairs at CPS, Inc. will act as the foremost authority in Scientific & Regulatory Affairs, managing all aspects of U.S. and global regulations (including EU, CAN, AUS, and others), as well as overseeing third-party certifications for our complete product range. This...
-
Director of Compliance
1 week ago
los angeles, United States Larson Maddox Full timeA global asset manager located in Los Angeles is looking to bring on an experience Compliance Director to their team. The Compliance Director will work with the Chief Compliance Officer to ensure the firm and its employees remain compliant, and oversee the Risk team. This role will be performed on a hybrid schedule in West LA.Responsibilities :Create,...
-
Director of Compliance
1 week ago
los angeles, United States Larson Maddox Full timeA global asset manager located in Los Angeles is looking to bring on an experience Compliance Director to their team. The Compliance Director will work with the Chief Compliance Officer to ensure the firm and its employees remain compliant, and oversee the Risk team. This role will be performed on a hybrid schedule in West LA.Responsibilities :Create,...
-
Compliance Director
3 days ago
Los Angeles, California, United States Larson Maddox Full timeAbout Larson Maddox: A global investment management firm with a strong focus on research and technology, overseeing billions in assets across various public equity strategies. The company has a reputation for innovation in investment management and a commitment to exceeding client expectations. The work environment fosters collaboration and values work-life...
-
Regulatory Affairs Director
6 days ago
Los Angeles, California, United States CPS Inc Full timeJob SummaryCPS Inc. is seeking a highly experienced and skilled Director of Regulatory Affairs to lead our regulatory efforts and ensure compliance with all relevant laws and regulations.Key ResponsibilitiesRegulatory Leadership: Provide strategic guidance on regulatory matters, identify and mitigate risks, and ensure compliance with all relevant laws and...
-
Regulatory Affairs Director
1 day ago
Los Angeles, California, United States CPS, Inc. (Food & Beverage Division) Full timeAbout the RoleCPS, Inc. (Food & Beverage Division) is seeking a highly skilled and experienced Regulatory Affairs Director to join our team. As a key member of our organization, you will play a critical role in ensuring compliance with U.S. and international regulations, while driving innovation and growth in our industry.Key ResponsibilitiesRegulatory...
-
Compliance Director
5 days ago
Los Angeles, United States Elevance Health Full timeCompliance Director Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our California Elevance Health PulsePoint locations. The Compliance Director will be responsible for directing foundational and strategic compliance responsibilities with consistent excellence that support the team...
-
Regulatory Compliance Specialist
1 week ago
Los Angeles, California, United States Concept Laboratories Full timeConcept Laboratories, a leading contract manufacturer of personal care and cosmetic products, is seeking a highly skilled Regulatory Affairs Assistant to join our team. This role is responsible for supporting the regulatory and product development teams to ensure compliance with all global regulatory requirements.**Key Responsibilities:**Assist in gathering...
-
Assistant Director, Athletic Compliance
2 months ago
Los Angeles, CA - University Park Campus, United States Human Resources Full timeUSC's Office of Athletic Compliance is seeking an Assistant Director, Athletic Compliance to join its team.The Assistant Director, Athletic Compliance will assist in developing, implementing, and maintaining a comprehensive, in-depth, and effective athletic compliance program by providing a professional service of monitoring, interpreting, analyzing, and...
-
Director, Compliance
5 days ago
Los Angeles, United States Larson Maddox Full timeAbout the Organization: A global equity manager with a strong emphasis on research and technology, managing billions in assets across various public equity strategies. The firm has a reputation for innovation in equity management and a commitment to exceeding client expectations. The work environment fosters teamwork and values work-life balance, offering a...
-
Ethics and Compliance Specialist 3
3 days ago
Los Alamos, New Mexico, United States EA-ETHICSEthics And Compliance Full timeJob Title: Ethics and Compliance Specialist 3Job Summary:The EA-ETHICS/Ethics And Compliance department is seeking a highly skilled Ethics and Compliance Specialist 3 to join our team. As a key member of our organization, you will be responsible for ensuring the highest standards of ethics and compliance are maintained across the organization.Key...
-
Regulatory Compliance Supervisor
2 weeks ago
Los Angeles, California, United States Crystal Stairs Full timeCrystal Stairs, Inc.Enhancing Family Lives throughChild Care Services, Research, and AdvocacyCOMPLIANCE MANAGERLocation: Los Angeles (100% On-Site)Position Overview:We are in search of a Compliance Manager to oversee the internal audit processes and the Quality Assurance Unit, ensuring alignment with the strategic objectives of the Agency. This role involves...
-
Regulatory Compliance Specialist
5 days ago
Los Angeles, California, United States City National Bank Full timeJob SummaryWe are seeking a highly skilled Regulatory Relations Manager to join our team at City National Bank. As a key member of our organization, you will be responsible for overseeing and managing our regulatory relations functions, ensuring compliance with all relevant laws and regulations.Key ResponsibilitiesOversee and manage a team of regulatory...
-
Financial Regulatory Compliance Specialist
2 weeks ago
Los Angeles, California, United States augmentjobs Full timeJob OverviewPosition Title: Financial Compliance AnalystPosition Summary: We are in search of a diligent and detail-focused Financial Compliance Analyst to become a vital part of our compliance division. In this role, you will be tasked with ensuring compliance with regulatory standards, internal policies, and procedures within our organization. Your...
