Senior Manager, Clinical Compliance Delegation Oversight
L.A. Care Health PlanAbout the role
Salary Range: $117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.)
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
Job Summary
The Senior Manager, Compliance Clinical Delegation Oversight provides leadership and subject matter expertise for the delegated clinical oversight, regulatory compliance, healthcare operations, process improvement, and change management. The Senior Manager is responsible for overseeing key Clinical Delegation Oversight functions, including but not limited to clinical monitoring, delegated clinical auditing, corrective action management, delegate education, regulatory implementation, and other clinical oversight activities supporting Participating Provider Groups (PPGs), Plan Partners, Specialty Health Plans, and other delegated entities. This position ensures delegated entities meet regulatory, contractual, and accreditation requirements and maintain effective clinical quality and compliance controls.
The Senior Manager will work closely with cross-functional departments responsible for Utilization Management, Care Management, Quality Improvement, Population Health, Medical Affairs, Compliance, Provider Network Management, Legal, and other operational teams to mature delegated clinical oversight practices. This position is responsible for identifying clinical compliance and operational performance risks, enhancing monitoring and auditing methodologies, implementing risk-based oversight strategies, and establishing mitigation plans that ensure compliance with federal and state regulatory requirements, contractual obligations, accreditation standards, and organizational expectations. The Senior Manager collaborates closely with executive/ senior management to establish goals that align with the company’s mission and vision.
Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports. Responsible for driving performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care. Oversee the development, implementation, administration, and maintenance of the department's programs, policies, and procedures. Responsible for driving management and performance to ensure that the team can make high-level decisions that impact on the success of L.A. Care
Duties
Strategic Leadership, Team Management, and Professional Development:
Lead the clinical delegation oversight program strategy, annual workplan, and operating cadence to ensure effective oversight of delegated clinical activities. Establish standardized processes, tools, and documentation requirements for delegation monitoring, audits, reporting, and issue remediation. Serve as a key compliance partner to clinical operations and enterprise compliance leadership on delegated oversight risks, trends, and priorities. Implement and provide guidance to the departmental and organizational processes and policies and work with senior and/or executive management to define, prioritize, and develop projects and programs.
Responsible for overseeing and managing the budgets of their respective departments. Manage staff and day-to-day activities in the department. Participates in the department budgeting process. Responsible for scheduling, training, performance, corrective actions, mentoring, and developing of the team(s). Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals. Mentors and develop staff, building technical and problem-solving skills across the team.
Clinical Compliance, Oversight Programs, and Performance Improvement:
Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.
Lead the development and execution of delegated clinical oversight programs that integrate monitoring, auditing, remediation, education, and performance improvement activities to ensure compliance with regulatory, contractual, accreditation, and organizational requirements. Direct development and monitoring of Corrective Action Plans (CAPs), including root cause analysis, timelines, deliverables, validation steps, and closure criteria. Partner with delegated entiti
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