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Health Plan Director of Compliance and Government Regulations
Health Plan Director of Compliance and Government RegulationsGovernment Jobs • Martinez, CA, US
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Health Plan Director of Compliance and Government Regulations

Health Plan Director of Compliance and Government Regulations

Government Jobs • Martinez, CA, US
30+ days ago
Job type
  • Full-time
Job description

Health Plan Director Of Compliance And Government Regulations

The Contra Costa Health Services Department is recruiting for one (1) qualified candidate interested in the Health Plan Director of Compliance and Government Regulations position assigned to the Contra Costa Health Plan (CCHP) located in Martinez, CA.

Contra Costa County Health Services is home to one of California's longest-standing public health plansContra Costa Health Plan (CCHP). For over 50 years, CCHP has delivered high-quality, community-based care to low-income and medically vulnerable populations across the county. As a Knox-Keene licensed HMO and Managed Medi-Cal Plan, CCHP offers a unique opportunity to serve the public while operating within a complex, evolving regulatory environment.

We are currently recruiting for a Director of Compliance and Government Regulations to lead the Plan's regulatory strategy and compliance functions. This role is critical to ensuring CCHP meets all federal, state, and contractual obligationsparticularly as we prepare to launch a Medicare-Medicaid Dual Special Needs Plan (D-SNP) in January 2026.

The Health Plan Director of Compliance and Government Regulations is part of the Plan's leadership for all compliance and regulatory oversight activities at Contra Costa Health Plan (CCHP). This includes responsibility for the Plan's regulatory filings, fraud and abuse program, audit readiness, corrective action planning, and coordination with state and federal agencies.

This position plays a strategic leadership role in ensuring that CCHP operates in alignment with CMS, DHCS, and DMHC requirements across Medi-Cal, Medicare, and dual-eligible populations.

We are looking for someone who :

  • Has significant experience in managed care and regulatory compliance
  • Understands California Health & Safety Codes, Knox-Keene regulations, and All Plan Letters (APLs)
  • Has overseen compliance audits, corrective action plans (CAPs), and regulator communications
  • Can build, lead, and mentor a multidisciplinary compliance team
  • Works effectively across department
  • Brings sound judgment, clarity, and responsiveness when navigating complex regulatory situations

What you will typically be responsible for :

  • Serving as a liaison to CMS, DHCS, DMHC, and County Counsel
  • Leading the Plan's Fraud, Waste, and Abuse (FWA) program, regulatory reporting, and internal investigations
  • Coordinating and submitting required documents to state and federal portals in a timely and accurate manner
  • Providing real-time regulatory interpretation and guidance to departments, providers, and leadership
  • Leading internal readiness efforts for audits, annual certifications, and new program implementation (e.g., D-SNP)
  • A few reasons why you might love this job :

  • You will directly shape compliance operations at a public health plan with significant community impact
  • You will join a mission-driven organization committed to delivering quality and comprehensive care and upholding the highest standards of regulatory excellence
  • The County offers competitive benefits
  • You will have the opportunity to work at the intersection of health care policy, service delivery, and public accountability
  • A few challenges you might face in this job :

  • CCHP operates in a highly regulated managed care environments in the country
  • You will need to manage complex, time-sensitive responses to state and federal regulators
  • Medi-Cal and Medicare programs are undergoing rapid changes under CalAIM and CMS guidance
  • Organizational change management and staff education will be critical as compliance standards evolve
  • Competencies Required :

  • Legal & Regulatory Navigation : Interpreting and applying complex regulations to real-world operations
  • Delivering Results : Driving accuracy, timeliness, and quality in all compliance deliverables
  • Strategic Thinking & Perspective : Anticipating long-term implications of policy and program shifts
  • Leadership : Building effective teams, systems, and compliance culture
  • Professional Integrity & Ethics : Modeling transparency, honesty, and accountability
  • Managing Organizational Complexity : Leading across departments and navigating public-sector systems
  • Cross-Divisional Collaboration : Supporting enterprise-wide coordination and education
  • Self-Management : Staying organized and focused in a dynamic environment
  • Minimum Qualifications :

    Experience : Two (2) years of full-time (or its equivalent experience) in a health care industry with responsibility for regulatory compliance and anti-fraud activities. Education : Possession of a bachelor's degree from an accredited college or university with a major in business administration or a closely related field. Desirable Qualifications :

  • Candidates with a Master's Degree or higher and who have experience in regulatory affairs are strongly encouraged to apply.
  • Experience in a public sector environment.
  • Experience in a Managed Care setting.
  • Selection Process :

  • Application Filing and Evaluation : Applications will be evaluated to determine which candidates will move forward in the next phase of the recruitment process.
  • Remote Oral Interview : Candidates that meet the minimum qualifications will be invited to participate in a remote oral interview. The assessment will measure candidates' competencies as they relate to the job. In the assessment, candidates must achieve an average passing score of 70% or higher on each of the competencies and an overall passing score of 70% or higher. These may include, but are not limited to : Delivering Results, Legal & Regulatory Navigation, Managing Organizational Complexity, Professional Integrity & Ethics, and Strategic Thinking & Perspective (Weighted 100%).
  • The assessments may be administered remotely using a computer or mobile device such as a tablet. You will need access to a reliable internet connection to take the assessment.

    Tentative Exam Dates

    Remote Oral Interview : 10 / 21 / 25-10 / 26 / 25

    For recruitment questions, please contact Health Services Personnel, Recruitment Team at Exams@cchealth.org . For any technical issues, please contact the Government Jobs' applicant support team for assistance at +1 855-524-5627.

    The Human Resources Department may change the examination steps noted above in accordance with the Personnel Management Regulations and accepted selection practices.

    Conviction History

    After you receive a conditional job offer, you will be fingerprinted, and your fingerprints will be sent to the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI). The resulting report of your conviction history (if any) will be used to determine whether the nature of your conviction conflicts with the specific duties and responsibilities of the job for which you have received a conditional job offer. If a conflict exists, you will be asked to present any evidence of rehabilitation that may mitigate the conflict, except when federal or state regulations bar employment in specific circumstances. Having a conviction history does not automatically preclude you from a job with Contra Costa County. If you accept a conditional job offer, the Human Resources Department will contact you to schedule a fingerprinting appointment.

    Disaster Service Worker

    All Contra Costa County employees are designated Disaster Service Workers through state and local law. Employment with the County requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency.

    Equal Employment Opportunity

    It is the policy of Contra Costa County to consider all applicants for employment without regard to race, color, religion, sex, national origin, ethnicity, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition, genetic information, military or veteran status, or other protected category under the law.

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    Director Of Compliance • Martinez, CA, US

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