Vendor Management Compliance Consultant

University of California - Los Angeles Health; Los Angeles (CA); On-site; USD 89,000 - 190,000; Full time

Job summary

University of California - Los Angeles Health seeks an experienced Compliance Consultant to support the ongoing administration and enhancement of the Plan's Medicare Advantage Vendor Management Program. This role ensures CMS, DMHC, and other regulatory compliance while strengthening vendor oversight and supporting new product development.

You will coordinate onboarding, contract management, documentation review, and ongoing oversight; monitor performance; support audits and reporting; and

Qualifications

• Bachelor's degree or equivalent in a healthcare/compliance related field.
• 5+ years of healthcare compliance or vendor management experience.
• Knowledge of Medicare Advantage and Part D regulatory requirements.
• Ability to translate regulatory requirements into operational processes and controls.
• Strong analytical and problem-solving skills for risk assessment and corrective actions.
• Experience supporting audits, regulatory inquiries, and investigations.

Responsibilities

• Coordinate vendor onboarding, classification, and contract management.
• Review and maintain vendor documentation, contracts, and compliance records.
• Monitor vendor performance and identify risks with corrective actions.
• Ensure compliance with Medicare Advantage, CMS, DMHC, and contractual requirements.
• Support policy and procedures development and annual reviews.
• Prepare regulatory, compliance, and operational reports and documentation.
• Support audits and regulatory inquiries and audit-readiness activities.
• Investigate potential compliance issues and document findings.
• Coordinate governance activities and maintain vendor management systems.

Skills

Analytical skills

Regulatory interpretation

Project management

Communication

Documentation preparation

Education

Bachelor's degree in Healthcare Administration / Business / Public Health / Compliance

Tools

SharePoint

Compliance systems

Reporting databases

Job description

Description

We are seeking an experienced Compliance Consultant to support the ongoing administration and enhancement of the Plan's Medicare Advantage Vendor Management Program. This role helps ensure compliance with CMS, DMHC, and other applicable regulatory requirements while strengthening vendor oversight, supporting operational effectiveness, and contributing to the successful development of new products and expanded services.

In this role, you will:

• Coordinate vendor onboarding, classification, delegation assessments, contract management and ongoing oversight activities.
• Review and maintain vendor documentation, contracts, inventories, compliance records, and related materials.
• Monitor vendor and First-Tier, Downstream, and Related Entity (FDR) performance, identify potential risks, and support corrective actions and process improvements.
• Ensure compliance with Medicare Advantage, CMS, DMHC, contractual, and organizational requirements.
• Support the development, maintenance, and annual review of policies, procedures, and operational guidance.
• Prepare and maintain regulatory, compliance, and operational reports, metrics, and supporting documentation.
• Support internal and external audits, regulatory inquiries, and ongoing audit-readiness activities.
• Investigate, document, and investigate potential compliance issues, incidents, and risks as appropriate.
• Coordinate governance activities, including preparing committee materials and presentations, documenting meeting minutes, and tracking action items.
• Maintain vendor management systems, SharePoint resources, and vendor-facing compliance materials, escalating when appropriate to remediate.
• Provide guidance, training, and ongoing support to vendors, Vendor Relationship Owners (VROs), Accountable Owners (AOs), and other stakeholders.
• Participate in special projects and initiatives supporting vendor management, compliance program objectives, system enhancements, regulatory requirements, new product offerings, service expansion, and operational improvements.

Salary Range: $88,900 - $190,300/annually

Qualifications

Required:

• A Bachelor's Degree in Healthcare Administration, Business Administration, Public Health, Compliance, or related field; and/or equivalent combination of education and experience
• 5 or more years of experience in healthcare compliance, regulatory oversight, delegated entity oversight, vendor management, or related healthcare operations
• Demonstrated thorough knowledge of Medicare Advantage and Part D regulatory requirements, including CMS guidance
• Knowledgeable of healthcare compliance program elements, risk assessment, methodologies, and regulatory monitoring practices
• Experience interpreting complex regulatory requirements and translating them into operational processes, controls, and procedures
• Strong analytical and problem-solving skills to identify compliance risks, determine root causes, and recommend corrective actions
• Experience conducting compliance reviews, monitoring activities, investigations or audit support functions
• Utilizes strong project management and organizational skills to manage multiple priorities and regulatory deadlines
• Communicates effectively in written and verbal format with all organization levels and external stakeholders
• Proficiency preparing reports, presentations, documentation, policies, and compliance-related communications
• Ability to build collaborative relationships with operational leaders, vendors, delegated entities, and regulatory stakeholders

Preferred:

• Knowledge of delegated entity, vendor, subcontractor, and FDR oversight requirements within managed care environments
• Possesses knowledge of California Department of Managed Health Care (DMHC) regulations applicable to Medicare Advantage plans
• Familiarity with compliance management systems, reporting databases, SharePoint, and workflow management platforms