Regulatory Affairs & Compliance Manager, Covered California

CalOptima; Orange (CA); Hybrid; USD 110,000 - 176,000; Full time

Benefits offered by this job

Partial Telework

Generous PTO

Tuition Reimbursement

Flexible scheduling

Career development opportunities

Job summary

CalOptima seeks a Manager of Regulatory Affairs and Compliance (Covered California) to lead our Office of Compliance. You will manage relationships with Covered California, DMHC and CMS, ensuring regulatory obligations are met across the organization and directing audit readiness and corrective actions.

The role blends leadership with regulatory oversight, requiring collaboration with leadership and staff to advance CalOptima Health's mission and responsibilities within California's health

Qualifications

• Bachelor's degree in a health care related field with 5 years of regulatory experience in health plans or similar.
• 3 years of compliance experience focused on Covered California within a managed care setting.
• 3 years of progressive leadership or supervisory experience.

Responsibilities

• Lead and develop the Regulatory Affairs and Compliance team for the Covered California program.
• Serve as regulatory liaison with Covered California, DMHC and CMS, managing communications and audits.
• Oversee regulatory filings, reporting, audits, and corrective action plans for compliance.
• Monitor statutory and regulatory updates and ensure timely impact analyses.
• Collaborate with executives and other departments to meet regulatory obligations.

Skills

Regulatory affairs

Compliance leadership

Project management

Communication skills

Education

Bachelor's degree in health care field

Master's degree (preferred)

Job description

CalOptima seeks a Manager of Regulatory Affairs and Compliance (Covered California) to lead our Office of Compliance. You will manage relationships with Covered California, DMHC and CMS, ensuring regulatory obligations are met across the organization and directing audit readiness and corrective actions.

The role blends leadership with regulatory oversight, requiring collaboration with leadership and staff to advance CalOptima Health's mission and responsibilities within California's health