Assistant Director, Regulatory Operations — Strategic Compliance

Cambia Health; Medford (OR); Hybrid; USD 128,000 - 208,000; Full time

Benefits offered by this job

Work from home options

Job summary

Cambia Health is seeking an Assistant Director of Clinical Regulatory Operations to lead a multi-location regulatory team in a hybrid setup. The role emphasizes compliance with CMS, state, NCQA, HIPAA/privacy, and contracts while driving improvements across Utilization Management, Care Management, Pharmacy and Payment Integrity.

The candidate will partner with Legal, Compliance, and Regulatory Affairs to standardize processes, implement monitoring tools, and deliver measurable program

Qualifications

• Bachelor's degree in healthcare related field is required.
• At least 5 years of leadership experience.
• 7 years in health insurance or managed care with a focus on regulatory compliance or clinical operations.

Responsibilities

• Lead regulatory operations team and partner with regulatory stakeholders.
• Enable operational efficiency within regulatory guardrails and improve affordability and member experience.
• Design and implement compliant monitoring, auditing, and reporting programs.
• Apply improvement science (PDSA, Lean, Six Sigma) to drive maturity and efficiency.
• Develop dashboards and automation to enhance compliance monitoring and decision-making.
• Oversee NCQA accreditation readiness activities and ongoing readiness.

Skills

CMS/compliance knowledge

Leadership experience

Regulatory compliance

Data analytics

Education

Bachelor's degree in Healthcare Administration

Master's preferred

Job description

Cambia Health is seeking an Assistant Director of Clinical Regulatory Operations to lead a multi-location regulatory team in a hybrid setup. The role emphasizes compliance with CMS, state, NCQA, HIPAA/privacy, and contracts while driving improvements across Utilization Management, Care Management, Pharmacy and Payment Integrity.

The candidate will partner with Legal, Compliance, and Regulatory Affairs to standardize processes, implement monitoring tools, and deliver measurable program