Regulatory Affairs & Compliance Analyst Sr. (Policies & Procedures)

05 Jun, 2020


Regulatory Affairs & Compliance Analyst Sr. (Policies & Procedures)

Orange, CA
Job Description

The Regulatory Affairs & Compliance Analyst, Sr. (Policies & Procedures) provides leadership, coordination, and support to ensure clear and concise communication, development, and implementation of CalOptima policies and procedures.  This position is also responsible for providing technical writing and policy analysis for CalOptima’s programs.  The overall objective of the position is to enhance and strengthen CalOptima’s policy infrastructure/platform/process for its programs.  This incumbent will also work to ensure CalOptima’s health care program policies reflect compliance with federal, state, and contractual obligations.  This position serves on projects and other assignments in the Regulatory Affairs & Compliance Department relating to policy objectives and policy initiatives. This position will interact with several levels of CalOptima staff including Executives and Management staff.


Position Responsibilities:

  • Plans, organizes, and develops project work plans.
  • Leads interdisciplinary workgroups in planning, evaluating, and executing specific multi-departmental policy initiatives.
  • Provides technical writing for CalOptima’s operational staff related to health care program policies and procedures.
  • Analyzes program policies for compliance with applicable statutory, regulatory, sub-regulatory, contractual, and other CalOptima obligations.
  • Provides guidance to internal customers on policy implications and recommendations for policy decisions regarding regulatory and contractual requirements affecting CalOptima policies.
  • Designs and develops process improvements for the Regulatory Affairs & Compliance (Policies & Procedures) Department with regards to policies and procedures development, interdepartmental communication efforts, and tracking regulatory guidance.
  • Monitors and reports on progress of the CalOptima annual policy reviews, provides evaluations, and assessments of results.
  • Facilitates workgroup meetings and evaluates impact of operational changes on policy development and revision.
  • Identifies and responds to the needs and expectations of a diverse set of internal customers that result in high level customer satisfaction.
  • Supports efforts related to regulatory audits for all CalOptima’s programs.
  • Other projects and duties as assigned. 



Required Skills


  • Draft policies that are clear, concise, and unambiguous along with superior writing skills.
  • Communicate clearly and concisely, both verbally and in writing, and has strong presentation skills.
  • Work collaboratively with internal departments to develop policies reflective of operational needs and in compliance with state and federal regulations, and contractual requirements.
  • Work with data, manipulate spreadsheets, and perform quantitative analysis.
  • Demonstrate strong organizational, analytical, problem solving, and project management skills.
  • Build consensus on strategies and messages among peers and stakeholders.
  • Adapt to constantly changing priorities in managing various projects simultaneously.
  • Work independently and as a team member on assigned projects.
  • Prioritize tasks according to internal and external deadlines.
  • Utilize and access computer and appropriate software (e.g. Microsoft: Word, Excel, PowerPoint) and job-specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position.






Required Experience


Experience & Education:

  • Bachelor’s degree in Health Services Administration, Public Health, Public Policy, or related field required. Master’s degree preferred.
  • 3 years of relevant work experience in health care industry or health plan requirements, including specific experience in policies and procedure development, Medi-Cal and/or Medicare programs required.
  • 3 years of experience with technical writing required.



Knowledge of: 

  • Knowledge of health care programs and policies, including Medi-Cal managed care.
  • Principles and practices of managed care.
  • Effective methods for coordinating the work of interactive groups.


Grade: L



Job Location
Orange, California, United States
Position Type
Learn more here

Job posted: 2020-06-05