My Insurance Services Inc
Compliance Officer — Healthcare (CalAIM / Medi-Cal)
Roseville, CA
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Full time
Company website
This is a foundational, hands-on role — you'll both design and operate MISI's compliance program, with no team beneath you initially. You'll be the single accountable owner for compliance, privacy, and fraud, waste, and abuse (FWA) prevention across MISI and its affiliated entity, Sprout, and you're as comfortable drafting a policy as you are sitting across from a managed-care auditor. Reports to the CEO.
About My Insurance Services Inc
Description
What You'll Do
- Develop, implement, and maintain the organization-wide compliance plan and code of conduct
- Build the program around the seven elements of an effective compliance program per federal/OIG guidance
- Conduct annual compliance risk assessments and maintain a prioritized work plan
- Serve as HIPAA Privacy Officer; draft and enforce privacy and security policies
- Inventory and execute Business Associate Agreements with vendors and partners
- Build and operate the FWA prevention program, including monthly OIG/SAM/Medi-Cal exclusion screening
- Maintain an anonymous reporting hotline and non-retaliation policy
- Serve as primary liaison for DHCS and managed-care plan audits
- Conduct internal audits, billing-compliance sampling, and manage grievance/appeal/incident resolution
- Report compliance status and risks to the CEO and governing body
What You Bring
- Bachelor's degree in a related field
- Minimum 5 years of healthcare compliance experience
- Working knowledge of HIPAA, 42 CFR Part 2, FWA frameworks, and Medi-Cal managed-care requirements
- Demonstrated ability to build compliance processes from the ground up
- Strong written communication skills — able to draft policies, reports, and audit responses independently
Nice to Have
- Certified in Healthcare Compliance (CHC), or able to obtain within 12 months
- Direct experience with CalAIM ECM and/or Community Supports
- Advanced degree (JD, MPH, MHA) or active RN licensure
- Experience serving as a HIPAA Privacy Officer
- Familiarity with behavioral-health and recuperative-care settings
Compensation & Growth
Base salary range: $120,000–$162,000 (Sacramento metro, healthcare sector), with credentials (CHC, RN) and direct CalAIM experience driving placement within the band. As MISI scales, this role is intended to grow into leading a full compliance department — a strong fit for someone looking to build and then lead.
Salary
$120,000 - $162,000 per year