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Regulatory Compliance Specialist II
2 months ago
The Regulatory Compliance Specialist II is a critical position within L.A. Care Health Plan, responsible for ensuring the organization's compliance with regulatory requirements. This role will play a key part in maintaining the company's reputation for quality healthcare services.
Key Responsibilities- Develop and implement audit procedures to ensure readiness for regulatory audits.
- Collaborate with internal Subject Matter Experts (SMEs) to understand regulatory processes and identify areas for improvement.
- Evaluate policies and procedures to ensure alignment with applicable regulations and guidelines.
- Provide recommendations to management for continuous process improvements.
- Track, trend, and analyze results of Quality Assurance (QA) scorecards for training and quality improvement.
- Bachelor's Degree in a related field.
- A minimum of 5 years of experience in regulatory auditing in a healthcare environment.
- Previous experience with Medi-Cal and Medicare in a managed care environment.
- Tableau experience preferred.
- Advanced computer proficiency, including Word, Excel, and Access.
- Strong analytical and team building skills.
- Ability to work effectively with diverse team members.
- Ability to formulate recommendations to improve quality and service delivery.
- Ability to multi-task and streamline day-to-day operations.
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 over 2 million members in five health plans.
