Senior Network Ops & Compliance Specialist

L.A. Care Health Plan; Los Angeles (CA); On-site; USD 89,000 - 142,000; Full time

Benefits offered by this job

Paid Time Off

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Volunteer Time Off

Job summary

L.A. Care Health Plan in Los Angeles, CA seeks a Network Operations Specialist III to translate regulatory requirements into actionable strategies and oversee major initiatives.

You will coordinate cross-functional teams, develop KPIs, monitor program health, and support audit readiness with thorough documentation and stakeholder communication. This role emphasizes compliance, performance tracking, and data-driven decision making.

Qualifications

• Bachelor's Degree; equivalent education/experience may be considered.
• At least 3 years in managed care/network operations, data analysis, or regulatory operationalization.
• Experience executing program plans, interpreting APLs/policy, preparing audit evidence, building KPIs/dashboards.
• Preferred: experience with provider communications/portal adoption and updating UPM.
• Skills: convert requirements into tasks, workflows, timelines and measurable outcomes; ensure compliance.

Responsibilities

• Translate regulatory and program requirements into actionable strategies and outcomes.
• Lead planning and execution of key initiatives and manage milestones.
• Coordinate cross-functional workgroups and maintain logs and updates.
• Develop KPIs and dashboards to monitor program health and risks.
• Ensure audit readiness and regulatory reviews are documented.

Skills

Program requirements

APL knowledge

KPI & dashboards

Cross-functional coordination

Written/verbal communication

Operational data analysis

Provider payments knowledge

Education

Bachelor's Degree

Job description

L.A. Care Health Plan in Los Angeles, CA seeks a Network Operations Specialist III to translate regulatory requirements into actionable strategies and oversee major initiatives.

You will coordinate cross-functional teams, develop KPIs, monitor program health, and support audit readiness with thorough documentation and stakeholder communication. This role emphasizes compliance, performance tracking, and data-driven decision making.