Compliance Manager

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

Position Summary:

The Compliance Manager to build and manage strategic partnerships with internal business units toward a common goal of enterprise-wide compliance excellence.  The Compliance Manager will report to the Director of Compliance and will have a diverse range of responsibilities associated with interpretation of state and federal regulations related to health care and Medicare Advantage Plans, improving collaboration and other aspects of embodying a culture of compliance.

General Duties/Responsibilities (May include but are not limited to):

• Audit and analyze processes, documentation, and data to identify any gaps in the effectiveness of Alignment Healthcare’s governance, Medicare Advantage compliance and control environment.
• Perform Annual Compliance Risk Assessment and audit High Risks
• Provide proactive consulting and facilitation of compliance, control, and governance processes for those areas under review. 
• Drive compliance culture through partnership with business process owners in assessment of key compliance metrics, applicable state and federal regulations, audit protocols and processes that ensure execution at best-in-class levels.
• Execute and manage audit engagement plans and oversee auditing and monitoring to ensure accurate and timely performance of all steps related to audits and special projects.
• Lead various work groups, including Auditing and Monitoring Committee, to provide assurance around the effectiveness and efficiency of various Alignment Healthcare operational processes as well as those of delegated/contracted entities.  The Compliance Manager will interact with leaders in many different areas and at many different levels.   
• Develop and maintain key working relationships across Alignment Healthcare related to compliance. 
• Working specifically with business unit leadership, the Compliance Manager will identify new and emerging compliance risks and then plan internally with audit and oversee monitoring and control of those risks.   This individual will oversee and manage those tasked with execution of specific audit engagements designed to test compliance and control practices.

Supervisory responsibilities:

N/A

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.       Minimum Experience:

a.       3+ years of audit, consulting, or Medicare Advantage compliance experience, or commensurate combined education/experience

2.       Education/Licensure:

a.       Bachelor’s degree

3.       Other:

a.       Successful track record in facilitating and managing audits

b.       Likes to focus on the "big picture" and thrives in a fast paced, multi-project work environment

c.       Computer literate (MS Word, Power Point, Excel). Proficiency with Excel functions and formulas

d.       Excellent communication skills, both oral and written

e.       Key Competencies

                                                               i.      Builds Trust: Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one's actions, including a high level of precision in work.

                                                             ii.      Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts compliance and Alignment Healthcare's overall success first.

                                                           iii.      Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints.

                                                           iv.      Interpersonal Effectiveness: Understands oneself, effectively manages emotions, listens, and communicates with respect, and builds trusting relationships.

1. Work Environment

1. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.       While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2.       The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.