Mandates Control Specialist, Principal

Your Role

The Mandates Control Group team is responsible for analyzing new laws and regulations, identifying the implications, and affected business areas, including business subject matter experts, preparing a work order for the project management team and/or the business to execute, and documenting compliance artifacts once implementation is complete. The Mandates Control Specialist, Principal will report to the Director, Mandates Control Group. In this role you will be responsible for driving key initiatives of the Mandates Control Group, including the end-to-end mandate intake activities, scoping for implementation and guidance on mandate validation.

Your Knowledge and Experience

• Requires a college degree or equivalent experience

• Requires at least 10 years of prior relevant experience

• Requires working understanding of health insurance operations, healthcare compliance, mandates, regulations, and legislative requirements of the Department of Managed Health Care and the Department of Health Care Services across all lines of business (commercial, Covered CA, self-funded, and Medi-Cal).

• Requires practical knowledge in leading and managing the execution of processes, projects, and tactics within Mandates.

• Requires advanced technical and functional expertise, business acumen, financial analysis skills, risk management, delegation skills, critical thinking, and decision-making skills.

• Requires knowledge of the Knox-Keene Act, California Code of Regulations Titles 22 and 28, and Code of Federal Regulations Title 42 regulatory compliance standards and processes

• Extensive experience in a legal or compliance department in a managed care organization preferred.

  Hybrid

  This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For

  teams, this means coming into the office two days each week.

  Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.