Hybrid: Clinical Regulatory Operations Lead

Cambia Health Solutions; Vancouver (WA); Hybrid; USD 128,000 - 208,000; Full time

Benefits offered by this job

Work from home options

Competitive benefits package

Generous paid time off

Job summary

Cambia Health Solutions seeks an Assistant Director Clinical Regulatory Operations to lead a regulatory operations team ensuring CMS, state, NCQA, and privacy compliance across Health Services Operations. This role partners with clinical and regulatory stakeholders to drive affordability, quality, and member experience within governance guardrails.

The ideal leader demonstrates change management, analytics, and a proven track record in regulatory programs, with the ability to scale processes

Qualifications

• Bachelor's degree in Healthcare Administration, Nursing, Public Health, or a related field (Master's preferred).
• 5 years of leadership experience.
• 7 years of health insurance or managed care experience focused on regulatory compliance, quality management, or clinical operations — or an equivalent combination of education and experience.

Responsibilities

• Partner with Regulatory Affairs, Quality, Legal, Compliance, and clinical business owners to identify, interpret, and operationalize new and evolving regulatory requirements across all HSO program areas.
• Facilitate operational simplification by aligning processes across teams and lines of business to reduce redundancy and scale compliant practices.
• Design and execute regulatory compliance programs using PDSA, Lean, Six Sigma to drive maturity and optimize resources.
• Establish and improve audit and monitoring processes with automation, dashboards, and real-time reporting.
• Lead NCQA accreditation readiness activities and oversee the Rapid Resolution Team and Inter-rater Reliability program.
• Handle management responsibilities including performance reviews, hiring, budgeting, and department goals.

Skills

Regulatory compliance

Leadership

Cross-functional collaboration

Data analytics

Project management

Budgeting

Policy development

Communication

AI tools familiarity

Process improvement

Education

Bachelor's degree in Healthcare Administration, Nursing, Public Health, or related field

Master's degree preferred

Tools

Dashboard development

Workflow automation

Lean/Six Sigma

Job description

Cambia Health Solutions seeks an Assistant Director Clinical Regulatory Operations to lead a regulatory operations team ensuring CMS, state, NCQA, and privacy compliance across Health Services Operations. This role partners with clinical and regulatory stakeholders to drive affordability, quality, and member experience within governance guardrails.

The ideal leader demonstrates change management, analytics, and a proven track record in regulatory programs, with the ability to scale processes