Compliance Consultant, MAPD Vendor Management

UCLA Health is hiring a Compliance Consultant for its Medicare Advantage Vendor Management Program in Los Angeles, CA. The role involves ensuring compliance with CMS and DMHC regulations, guiding stakeholders, developing program procedures, and improving compliance practices. Key responsibilities include monitoring regulatory submissions, assessing compliance risks, and leading training initiatives. The position requires extensive knowledge of healthcare regulations and is a full-time role with a salary range of $83,800-$179,400 annually.
Description

We are seeking a highly experienced Compliance Consultant to provide expert-level support in the development, implementation, and ongoing maintenance of our Medicare Advantage Vendor Management Program (“Program”). This position is crucial for ensuring that the organization remains in full compliance with CMS, DMHC, and other regulatory bodies, while also supporting the viability of new product offerings through vendor oversight. The ideal candidate will possess a deep working knowledge of CMS and DMHC regulatory requirements and industry best practices as they relate to Medicare Advantage health plan operations.

Key Responsibilities:
• Serve as a subject matter expert to guide internal and external stakeholders (i.e., vendors, FDRs) in maintaining regulatory compliance with CMS, DMHC, and other applicable healthcare regulations and settings.
• Collaborate with cross-functional teams to develop, implement, and maintain Program procedures tailored to the organization’s structure, operations, and product offerings.
• Provide day-to-day support for the execution of the Program’s compliance elements to ensure ongoing adherence with regulatory standards and enhance operational efficiency.
• Analyze the Program’s compliance practices and identify areas for improvement or modification based on regulatory changes or industry best practices.
• Effectively communicate compliance requirements and strategies across various levels of the organization.
• Monitor regulatory data submissions from all data contributors and conduct timely reviews of actionable system tasks.
• Assess and document potential compliance risks and provide actionable recommendations to mitigate these risks.
• Lead and support compliance training initiatives for staff and business partners, ensuring a strong understanding of relevant system operations, regulations and Program procedures.
• Collaborate with key stakeholders to ensure that all compliance requirements are integrated into business processes and operational workflows.
• Stay current with changes in relevant laws, regulations, and best practices to ensure the Program and organization’s compliance efforts remain up-to-date.

Salary Range: $83,800-$179,400/annually