Kaiser Permanente

Senior Director Compliance, Risk Adjustment

Kaiser Permanente

Oakland, CA, USA
Full-TimeDepends on ExperienceSenior LevelMasters
Job Description

Welcome to Kaiser Permanente, a leading healthcare organization dedicated to providing high-quality care to our members. We are currently seeking a highly experienced and skilled Senior Director of Compliance, Risk Adjustment to join our team. In this role, you will be responsible for overseeing our compliance and risk adjustment programs, ensuring that our organization operates in accordance with all regulatory requirements. As a key member of our leadership team, you will have the opportunity to make a significant impact on our organization's success and the well-being of our members. To excel in this role, you must possess a thorough understanding of compliance and risk management principles, along with strong leadership and communication skills. If you are passionate about promoting ethical and compliant practices in the healthcare industry, we invite you to apply for this exciting opportunity at Kaiser Permanente.

  1. Develop and implement compliance and risk adjustment strategies and initiatives to ensure organizational compliance with all applicable laws, regulations, and policies.
  2. Monitor and assess compliance risks and recommend proactive measures to mitigate potential issues.
  3. Lead and manage a team of compliance and risk professionals, providing guidance and support to ensure the effective execution of compliance and risk management programs.
  4. Collaborate with cross-functional teams to promote a culture of compliance and risk management throughout the organization.
  5. Conduct regular audits and assessments to identify compliance gaps and areas for improvement, and develop and implement corrective action plans.
  6. Stay up-to-date on regulatory changes and industry best practices, and communicate relevant updates and recommendations to senior leadership.
  7. Serve as the primary point of contact for regulatory agencies and external auditors, ensuring timely and accurate responses to inquiries and requests.
  8. Develop and deliver training programs and materials to educate employees on compliance and risk management policies and procedures.
  9. Monitor and report on compliance and risk management program effectiveness to senior leadership and make recommendations for improvement.
  10. Foster a culture of integrity, accountability, and ethical conduct throughout the organization.
  11. Collaborate with other departments, including legal, finance, and operations, to ensure alignment and consistency in compliance and risk management practices.
  12. Represent Kaiser Permanente in external compliance and risk management forums and conferences.
  13. Maintain confidentiality and handle sensitive information in a professional and ethical manner.
  14. Adhere to all departmental and organizational policies and procedures.
  15. Continuously evaluate and improve processes and procedures to enhance the efficiency and effectiveness of compliance and risk management programs.
Where is this job?
This job is located at Oakland, CA, USA
Job Qualifications
  • Extensive Experience In Healthcare Compliance: The Ideal Candidate Should Have At Least 10 Years Of Experience In Healthcare Compliance, Preferably In A Leadership Role. This Includes A Deep Understanding Of Federal And State Laws, Regulations, And Guidelines Related To Risk Adjustment.

  • Strong Knowledge Of Risk Adjustment Methodologies: The Candidate Should Possess A Strong Understanding Of Risk Adjustment Methodologies, Including Hierarchical Condition Category (Hcc) Coding, Risk Score Calculation, And Data Validation. This Will Enable Them To Effectively Develop And Implement Risk Adjustment Strategies.

  • Proven Track Record In Implementing Compliance Programs: The Candidate Should Have A Track Record Of Successfully Implementing Compliance Programs In Large Healthcare Organizations. This Includes Developing Policies And Procedures, Conducting Audits, And Providing Training To Employees.

  • Excellent Communication And Leadership Skills: As A Senior Director, The Candidate Will Be Responsible For Overseeing A Team Of Compliance Professionals And Working Closely With Other Departments. Therefore, Strong Communication And Leadership Skills Are Essential For This Role.

  • In-Depth Knowledge Of Healthcare Regulations And Industry Trends: The Ideal Candidate Should Have A Comprehensive Understanding Of The Constantly Evolving Healthcare Regulatory Landscape And Industry Trends. This Will Enable Them To Anticipate Potential Compliance Risks And Proactively Develop Strategies To Address Them.

Required Skills
  • Quality Assurance

  • Communication Skills

  • Project Management

  • Data Analysis

  • Leadership

  • Compliance Management

  • Risk assessment

  • Risk Mitigation

  • Regulatory compliance

  • Compliance Training

  • Policy Development

  • Compliance Auditing

Soft Skills
  • Communication

  • Conflict Resolution

  • Leadership

  • Interpersonal Skills

  • creativity

  • Critical thinking

  • Teamwork

  • Adaptability

  • Problem-Solving

  • Time-Management

Compensation

According to JobzMall, the average salary range for a Senior Director Compliance, Risk Adjustment in Oakland, CA, USA is $150,000 - $200,000 per year. However, this can vary depending on the specific company, industry, and individual's level of experience and qualifications. Some companies may offer higher salaries or additional benefits such as bonuses, stock options, and healthcare benefits. It is recommended to research the specific company and industry to get a more accurate salary range for this position.

Additional Information
Kaiser Permanente is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedOctober 25th, 2024
Apply BeforeJune 21st, 2025
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About Kaiser Permanente

Kaiser Permanente is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield.

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