Healthcare Compliance Manager

• Oversee daily operations of the Compliance and Ethics Department, including auditing, monitoring, and training
• Lead regulatory filings and reporting, including DMHC, HIOS, and SERFF submissions
• Serve as a subject matter expert on compliance requirements, including Knox-Keene and DMHC regulations
• Partner with internal teams to interpret and implement new regulatory requirements
• Oversee internal and external audits and track corrective actions
• Supervise Compliance Analysts and support team development and performance management
• Lead compliance-related communications, including newsletters, manuals, and publications
• Support development of departmental strategies, performance tracking, and business planning
• Monitor and respond to hotline reports, escalating and analyzing compliance concerns as needed
• Participate in cross-functional initiatives and represent compliance in organizational projects
• Ensure adherence to WHA’s Privacy and Information Security programs and regulatory requirements
• Maintain confidentiality and uphold compliance with HIPAA and other privacy standards
• Perform other duties and special projects as assigned

• Bachelor’s degree in Compliance, Healthcare Administration, Legal/Regulatory Affairs, or a related field
• 5+ years of experience in healthcare compliance, regulatory, auditing, or governance roles
• Professional certification such as Certified Healthcare Compliance (CHC) preferred
• Strong knowledge of regulatory frameworks including NCQA, Knox-Keene, HIPAA, Covered California, and related requirements
• Experience leading compliance initiatives, audits, and regulatory filings
• Strong leadership, communication, and analytical skills
• Ability to manage multiple priorities and collaborate across departments
• Proficiency with standard business applications

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law. (EOE)

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you — and excellent customer service for our members.

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