Job Abstract

Take on a key role within a world-class health organization. Provide important expertise that enables the efficient operation of a complex health system. Take your professional expertise to the next level. UCan do all this and more at UCLA Health.

Reporting directly to the FPG Chief Financial Officer, you will lead periodic risk assessments, management audits, and reporting procedures to identify potential areas of compliance vulnerability and risk. You will be responsible for developing and implementing preventive and corrective action plans to mitigate identified risks. In addition, you will manage and coordinate Medicare external audits, risk adjustment validation audits, data validation audits and any other CMS ad hoc or targeted audits. You will:

· Serve as primary compliance contact

· Develop and maintain the comprehensive Medicare Compliance Program

· Coordinate and communicate Medicare compliance activities and programs

· Develop and update Medicare compliance policies and procedures

· Oversee and ensure organizational compliance with program requirements and regulations for expansions, Plan Benefit Packages (PBP), etc.

· Collaborate with internal auditors to ensure adequacy of internal controls

· Manage and coordinate Medicare external audits

· Provides corrective action plans

· Develop, implement and lead UCLA Health’s Medicare Compliance Committee

Salary range: $89,900.00-$216,700.00 Annual

We’re seeking an independent, detail-oriented professional with:

· A Bachelor’s degree in healthcare administration or related field – Master’s preferred

· Five or more years of experience with Medicare managed care programs

· Knowledge of CMS and Medicare Advantage Prescription Drug Plans and Special Needs Plans and Health Care Compliance Certification a plus

· Excellent analytical, interpersonal, project management and organizational skills

· Ability to persuade and instill effective cooperation and compliance

UCLA Health is a world-renowned health system with four award-winning hospitals and dozens of primary care practices, specialty practices, urgent care centers and other ancillary locations throughout metro Los Angeles. We are also home to the David Geffen School of Medicine, an internationally-respected leader in medical education and research. Through the efforts of our outstanding people, we have become Los Angeles’ trusted provider of exceptional, compassionate patient care. If you’re looking to experience greater challenge and fulfillment in your career, UCan at UCLA Health.