Vice President Financial Risk Management Jobs in Riverside, CA

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Vice President of Compliance is a senior leader responsible for leading, evolving, and continuously strengthening Alignment Healthcare's enterprise-wide Compliance Program across Medicare Advantage and other lines of business. This leader collaborates closely with operational business owners to embed a culture of compliance, ethics and integrity throughout the organization. This role drives outcomes in regulatory adherence, HIPAA privacy, compliance training, investigations, and policy governance at a strategic level.
The VP, Compliance is instrumental in protecting Alignment Healthcare's mission by ensuring the organization operates within applicable federal and state regulatory frameworks - and by building scalable systems, high-performing teams, and a data-driven compliance culture that makes compliance a sustainable competitive strength.

Job Responsibilities:

Lead and Evolve the Enterprise Compliance Program. Design, implement, and continuously enhance and mature a comprehensive, data-driven, risk-based Compliance Program aligned with CMS and State requirements, and organizational strategy. Serve as the overall owner of the Compliance Plan and all program documentation, driving annual review and updates to reflect the regulatory landscape and Business growth objectives.

Provide Strategic Regulatory Guidance to Executive Leadership. Monitor, interpret, and communicate emerging and enacted regulatory and enforcement requirements and trends to the Chief Compliance Officer and senior management. Translate complex regulatory requirements into clear, actionable business strategies, enabling proactive, timely and risk informed decision making across the enterprise.

Drive Compliance Monitoring, Auditing, and Reporting. Oversee the design and execution of compliance monitoring and auditing plans, ensuring data-driven, actionable insights and executive-level reporting. Establish dashboards and reporting that enable real-time visibility in compliance risk, control effectiveness and program performance.

Investigations. Direct the investigation of compliance violations and allegations of HIPAA privacy breaches, ensuring they are consistent, defensible and aligned with Alignment and regulatory expectations. Maintain investigation logs and escalation pathways including board-level escalation where appropriate.

Govern HIPAA Privacy and Data Protection Compliance. Ensure organizational adherence to HIPAA privacy and security rules, including oversight of privacy incident response, breach notifications, and remediation plans. Partner with IT, Legal, and operational leaders to embed data protection standards into business processes and technology platforms.

Champion Compliance Training and Culture. Oversee compliance education programs ensuring it is strategically aligned, role based and measurable in effectiveness. Promote a culture of accountability, speak-up culture and ethical decision making.

Compliance Policies. Lead the development, revision, and organization-wide communication of compliance and HIPAA policies, ensuring clarity, legal alignment, and operational usability. Coordinate with cross-functional partners to integrate compliance requirements into business workflows, contracts, and vendor relationships.

Team Leadership. Develop, retain and recruit when appropriate a high caliber, scalable Compliance organization. Create clear succession pipeline as #2 to the Chief Compliance Officer.

Job Requirements:

Experience:

Required:

• Significant MAO Compliance leadership experience (5+ required - 10+ years preferred) interfacing with CMS and State regulators related to audits and enforcement actions as well as internal and external business partners.
• Experience operating within a complex, fast-scaling enterprise health plan or value-based care organization.

Preferred:

• Experience in an MAO undergoing rapid growth, integration, or transformation.
• Prior experience directly supporting a Chief Compliance Officer or serving in a #2 Compliance leadership role with Board-level exposure.

Education:

Required: Bachelor's degree in Healthcare Administration, Legal Studies, Business, Public Health, or a related field; or equivalent professional experience in lieu of degree.

Preferred: Advanced degree (or equivalent graduate-level education in a compliance-adjacent discipline.

Specialized Skills - Emphasis on

• Data Analytics/Compliance Intelligence
• Enterprise Risk Alignment
• Executive-level communication, engagement and collaboration

• Compliance Management (Advanced) - Ability to monitor and assess systems to ensure adherence to industry standards, corporate policy, and regulatory requirements; establish frameworks for adherence, conduct audits, and implement corrective measures.
• Regulatory Compliance (Advanced) - Deep understanding of organizational adherence to laws, regulations, and guidelines relevant to Medicare Advantage healthcare operations, including CMS, OIG, and state regulatory frameworks.
• Health Care Risk Management (Advanced) - Identifying, assessing, and managing risks in the healthcare industry; knowledge of healthcare laws and regulations, patient safety, and organizational risk mitigation.
• Compliance Reporting (Advanced) - Ability to systematically collect, organize, and present information to demonstrate adherence to legal and regulatory frameworks, with meticulous record-keeping and effective communication of compliance status.
• Health Laws (Advanced) - Specialized knowledge of the legal and regulatory requirements related to healthcare services, including patient care, medical records, insurance, HIPAA, and healthcare policy.
• Incident Reporting & Investigation (Advanced) - Skilled in documenting, communicating, and managing compliance incidents, with ability to lead complex investigations and maintain audit-ready records.
• Ethical Judgment & Integrity (Advanced) - Necessary to uphold organizational values, maintain trust in adherence to legal and organizational policies, and model ethical conduct throughout the compliance function.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $227,952.00 - $341,928.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER:Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information.Please be advised that Alignment Health and its subsidiaries 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 Federal Trade Commission athttps://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please emailcareers@ahcusa.com.