Director of Compliance - Health Plan (Remote/Hybrid)

Montage Health; Monterey (CA); Hybrid; USD 120,000 - 165,000; Full time

Job summary

Aspire Health, in collaboration with Montage Health, seeks a seasoned Compliance Leader based in Monterey, CA. The role focuses on planning, designing, and refining the Compliance Program to meet state and federal requirements.

You will coordinate audits, trainings, and regulatory filings, while driving risk assessments and action plans across the organization. Hybrid or remote work options may be available for qualified candidates.

Qualifications

• 7+ years experience in health plans
• 3-5 years management experience
• Advanced degree in law/health administration preferred
• CHC or CIA certification preferred or obtainable within 6 months
• Strong internal audit knowledge and reporting requirements
• Knowledge of Knox-Keene Act and state/federal reporting requirements

Responsibilities

• Serve as primary contact with CMS and DMHC in California
• Maintain CMS Regional Office communication on Medicare complaints and CAPs
• Develop and implement compliance training and education
• Prepare state and federal filings in CMS HPMS or DMHC portal
• Create risk assessments and work plans for compliance effectiveness
• Monitor KPIs and conduct internal audits to detect non-compliance
• Coordinate FWA investigations with SIU and enforce privacy/security standards
• Prepare compliance reports to Board and Executive Management

Skills

Internal Audit

HIPAA & FWA

Regulatory Knowledge

Communication Skills

Collaboration

MS Office

Education

Advanced degree in law/health administration

CHC or CIA preferred

Experience substituted for education

Tools

HPMS

DMHC portal

Job description

Aspire Health, in collaboration with Montage Health, seeks a seasoned Compliance Leader based in Monterey, CA. The role focuses on planning, designing, and refining the Compliance Program to meet state and federal requirements.

You will coordinate audits, trainings, and regulatory filings, while driving risk assessments and action plans across the organization. Hybrid or remote work options may be available for qualified candidates.