Compliance Manager at Western Health Advantage – Sacramento, California

Department: Compliance and Ethics
Position Type: Full-Time/Exempt
Location: Sacramento, CA/Hybrid
Travel: Occasional
Salary: $115,000 - $130,000 Annually

"Our purpose is strong, our impact is lasting, join us on the journey"
Western Health AdvantageDrive Compliance. Strengthen Integrity.
Western Health Advantage is seeking a Compliance Manager to lead the day-to-day operations of the Compliance and Ethics Department. In this role, you will oversee auditing, monitoring, regulatory reporting, and compliance initiatives while serving as a subject matter expert on Knox-Keene and DMHC requirements. You will partner closely with internal leaders to ensure regulatory alignment, mitigate risk, and support a culture of integrity and accountability across the organization.

What You’ll Do

• Oversee daily operations of the Compliance and Ethics Department, including auditing, monitoring, and training
• Lead regulatory filings and reporting, including DMHC, HIOS, and SERFF submissions
• Serve as a subject matter expert on compliance requirements, including Knox-Keene and DMHC regulations
• Partner with internal teams to interpret and implement new regulatory requirements
• Oversee internal and external audits and track corrective actions
• Supervise Compliance Analysts and support team development and performance management
• Lead compliance-related communications, including newsletters, manuals, and publications
• Support development of departmental strategies, performance tracking, and business planning
• Monitor and respond to hotline reports, escalating and analyzing compliance concerns as needed
• Participate in cross-functional initiatives and represent compliance in organizational projects
• Ensure adherence to WHA’s Privacy and Information Security programs and regulatory requirements
• Maintain confidentiality and uphold compliance with HIPAA and other privacy standards
• Perform other duties and special projects as assigned

What You’ll Bring

• Bachelor’s degree in Compliance, Healthcare Administration, Legal/Regulatory Affairs, or a related field
• 5+ years of experience in compliance, regulatory, auditing, or governance roles
• Professional certification such as Certified Healthcare Compliance (CHC) preferred
• Strong knowledge of regulatory frameworks including NCQA, Knox-Keene, HIPAA, Covered California, and related requirements
• Experience leading compliance initiatives, audits, and regulatory filings
• Strong leadership, communication, and analytical skills
• Ability to manage multiple priorities and collaborate across departments
• Proficiency with standard business applications

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law. (EOE)

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you — and excellent customer service for our members.

*WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Please be advised that Western Health Advantage will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams’ option.’