Senior Managed Care Operations & Compliance Lead

University of California - San Diego Medical Centers; San Diego (CA); On-site; USD 100,000 - 188,000; Full time

Job summary

The University of California - San Diego Medical Centers seeks a senior operational resource to research and implement complex regulatory, contractual, and reimbursement requirements, with a focus on managed care operations and DOFR logic in Epic Tapestry.

You will lead cross-functional initiatives, translate regulatory needs into actionable tasks, and ensure compliance while improving contracts and system configurations.

Qualifications

• Seven or more years of related experience or a Bachelor's degree plus three years of related experience.
• Thorough knowledge of managed care contracting functions and operations.
• Ability to research, interpret, and apply regulatory and contractual requirements.

Responsibilities

• Research and implement complex regulatory, contractual, and reimbursement requirements.
• Lead cross-functional operational initiatives and identify emerging risks.
• Translate complex requirements into practical operational tasks and system configurations.

Skills

Regulatory knowledge

Contract management

Data analysis

Process improvement

Stakeholder communication

DOFR logic understanding

Policies & compliance

Education

Bachelor's degree in related area

Tools

Epic Tapestry

MS Office

Job description

The University of California - San Diego Medical Centers seeks a senior operational resource to research and implement complex regulatory, contractual, and reimbursement requirements, with a focus on managed care operations and DOFR logic in Epic Tapestry.

You will lead cross-functional initiatives, translate regulatory needs into actionable tasks, and ensure compliance while improving contracts and system configurations.