apree health brings together a best-in-class engagement platform with an advanced primary care model to provide a vastly better health and care experience, improve outcomes, and significantly lower the total cost of care for a population.
Job Description Summary
Responsible for managing regulatory compliance functions defined by the California Department of Managed CareHow will you make an impact & Requirements
Regulatory Compliance Manager
The Regulatory Compliance Manager position requires responding to various Annual Program Letters throughout the year due to the organization's Knox Keene license. This includes tasks such as State of Emergency filings. The position also requires managing the Department of Managed Health Care (DMHC) Audits conducted every 3 years, and overseeing Compliance Performance Effectiveness audits throughout the year.
Additional responsibilities include handling attestation requests, overseeing the First Tier, Downstream or Related Entity (FDR) Oversight Program, and managing Compliance 360 for Medicaid & Medicare guidance. The Regulatory Compliance Manager also stays informed about regulatory changes, such as the 2025 Medicare Physician Fee Schedule and the 2026 MA Proposed Rule and participates in monthly regulatory meetings to ensure compliance across business units.
Primary duties may include, but are not limited to:
Responsible for managing regulatory compliance functions defined by the California Department of Managed Care
Develops, implements and maintains formal compliance structure and computer and filing systems for compliance materials.
Create the structure and processes necessary to manage filings and related activities.
Manages process for drafting all policy language and reviews all written materials for compliance with state and federal regulations, as well as contractual requirements.
May interact with legal department to review and evaluate required state regulatory filings.
Requirements:
Requires a BA/BS in a related field
Minimum of 5 years related regulatory or contract compliance; or any combination of education and experience, which would provide an equivalent background.
Ability to analyze, write and integrate highly technical information into action plans strongly preferred.
